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Flexor Hallucis Longus Tenosynovitis M77.9 726.90

 

synonyms: FHL tendinitis, FHL tendinopathy

FHL Tenosynovitis ICD-10

  • M77.9:Enthesopathy, unspecified

FHL Tenosynovitis ICD-9

  • 726.90 Enthesopathy of unspecified site; capsulitis NOS; perarthritis NOS; tendinitis NOS

FHL Tenosynovitis Etiology / Epidemiology / Natural History

FHL Tenosynovitis Anatomy

FHL Tenosynovitis Clinical Evaluation

  • Rare condition usually in ballet dancersor 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 Mortiseankle 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

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