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Tibialis anterior tendon (TAT) rupture is an uncommon musculoskeletal condition that is rarely encountered by neurologists.1 Most patients present with foot drop and pain and may be misdiagnosed as a peroneal mononeuropathy or L5 radiculopathy. Clinical recognition and distinction of this entity from other causes of foot drop are important for neurologists. We describe two patients with spontaneous TAT ruptures who presented for neurologic consultation for suspected peroneal neuropathies.
Case 1.
A 73-year-old man with a history of atrial fibrillation and hypertension was walking on his treadmill when he noted a painless “pop” in his right anterior ankle followed by “flopping” of his foot. A few days later, he noted swelling on the anterior aspect of his ankle and difficulty dorsiflexing his right foot. He denied back pain and bladder dysfunction. Neurologic examination demonstrated mild weakness in right ankle dorsiflexion with normal strength in all other muscles including toe extension and ankle eversion and inversion. There was swelling on the anterior surface of the right ankle (figure, A). The extensor hallucis longus and digitorum longus tendons were intact, but the TAT was not palpable …
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