Question: I had six months of ankle pain, diagnosed as PTT at the onset. I had been doing a lot of walking. No MRI at that time. Doctor gave me a cortisone shot which, that evening, made the area even more painful. Rest, compression, massage, ibuprofen on rare occasions, and after six months, the pain in that area was completely gone. A week later I developed mild pain in the peroneal area and minor swelling in the area after walking or at the end of the day. Sometimes I felt the tendon vibrating. New podiatrist ordered an MRI and only findings were "longitudinal split tear in the distal portion of the posterior tibial tendon beginning at the level of the medial malleolus and extending inferiorly to the insertion point." Everything else, including all tendons, ligaments, ankle bone, etc., was normal. I am now in a cast for six weeks, physical therapy and orthotics to follow. The doctor has assured me that this type of tear will heal. I do not want surgery on an otherwise normal ankle. My question is: why in the area of the tear (tibial tendon) is there no pain, while the area of pain (peroneal tendon) appears as normal on the MRI? It almost appears as though the radiologist was looking at the wrong side of the ankle when he saw the tear.

Thank you. When I saw that a surgeon was answering my question (thought it would be a podiatrist) I was apprehensive, thinking that you would say surgery was necessary. It is reassuring to see that you agree with my doctor's assessment and treatment plan. I have no further questions and I thank you very much.