Chronic Non-specific Tendovaginitis of Tibialis Posterior.

Non-specific tendovaginitis is a common cause of pain and disability, especially in relation to the wrist and ankle and to the proximal parts of the flexor sheaths of the fingers. Many papers have been written describing the condition in general and the features when particular tendon sheaths are involved, but few accounts have concerned the tendon of the tibialis posterior. Lapidus and Seidenstein (1950) referred to the first time this condition was described by Kulowski in 1936 and reported three patients with effusion into the tendon sheath. Lipscomb (1950) stated that this sheath was involved in 16 per cent of a series of patients he reviewed. Short accounts are given in the text-books of Campbell (1956) and DuVries (1959). There are reports of the condition being associated with reduplication of the tendon (Ghormley and Spear 1953) and with partial rupture (Key 1953). Fowler (1955) mentioned notable enlargement of the lower part of the tendon, and the fact that some of his histological sections showed deposits of haemosiderin in the synovium raised the possibility that the condition could be due to recurrent haemorrhage into the sheath. Burman (1953) found calcaneonavicular synostosis in one patient and fracture of the sustentaculum tali in another.