Flexor Hallucis Longus (FHL) Tenosynovitis
synonyms: FHL tendinitis, FHL tendinopathy
FHL Tenosynovitis ICD-9
FHL Tenosynovitis Etiology / Epidemiology / Natural History
FHL Tenosynovitis Anatomy
FHL Tenosynovitis Clinical Evaluation
- Rare condition usually in ballet dancers or patients exposed to repetitive trauma
- Poorly localized posterior ankle pain exacerbated by acute plantar flexion
- Pain in the posteromedial ankle when running , walking, or climbing stairs.
- Tenderness and swelling behind the medial malleolus.
- Pain, clicking or catching inthe posteromedial ankle with motion of the hallux
- Passive extension of the great toe is greater when the foot is plantarflexed.
- May have hallucis IP triggering
- Pain reproduced with active plantar flexion of the hallux against resistance.
FHL Tenosynovitis Xray / Diagnositc Tests
- A/P, Lateral and Mortise ankle xrays. Evaluate lateral xray for an fracture of the trigonal process or the presence of an os trigonum
- Consider dynamic views to demonstrate posterior impingement in maximal planter flexion.
FHL Tenosynovitis Classification / Treatment
- Activity modifications (no pointe for ballet dancers), NSAIDs, consider hard soled shoe for extreme cases.
- Consider surgical release of the FHL fibro-osseous tunnel if fails conservative treatment.
FHL Tenosynovitis Associated Injuries / Differential Diagnosis
FHL Tenosynovitis Complications
FHL Tenosynovitis Follow-up Care
FHL Tenosynovitis Review References
|
