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TP OVERLOAD/MEDIAL TIBIAL STRESS SYNDROME

Rheumatology

TP OVERLOAD/MEDIAL TIBIAL STRESS SYNDROME

1. Specturm of disease: pain along TP origin, pain along medial gastroc-soleus origin, progression to involve tibial periosteum (periostitis), tibial stress fracture.

2. TP can be put at mechnical disadvantage by pes planus or calcaneal eversion. RA can cause rupture of the TP tendon.

3. Risk factors: pes planus, calcaneal eversion, toe-walking/running, rapid increase in exercise.

4. A dysfunctional TP allows the calcaneus to rise in valgus during plantar-flexion (when viewed from behind during heel-raise).

5. Analgesia, ice, activity modification, foot orthoses. If patient does not improve, image to rule out periostitis or stress fractures.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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