Nathan Thakur, MD, David A. Leswick, MD, FRCPC

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Case of the Month #167: Flexor Hallicus Longus Tendon Tear Distal to the Master Knot of Henry Nathan Thakur, MD, David A. Leswick, MD, FRCPC Canadian Association of Radiologists Journal Volume 62, Issue 2, Pages 154-157 (May 2011) DOI: 10.1016/j.carj.2009.12.006 Copyright © 2011 Canadian Association of Radiologists Terms and Conditions

Figure 1 (A) Sagittal turbo-spin echoT2 (time to echo [TE] 96 ms, time to repetition [TR] 3800 ms) at the left great toe; fluid in the flexor hallicus longus (FHL) tendon sheath with redundancy, attenuation, and irregularity of the FHL tendon is seen (white arrows); a first metatarsal-phalangeal joint effusion is also present (grey arrow). (B) Coronal (short axis) proton density fat saturated (TE 14 ms, TR 2210 ms) image through the left foot at the level of the first metatarsal-phalangeal joint sesamoid bones; high signal at the expected location of the FHL tendon (white arrow) represents tendon attenuation and fluid filling the tendon sheath. Canadian Association of Radiologists Journal 2011 62, 154-157DOI: (10.1016/j.carj.2009.12.006) Copyright © 2011 Canadian Association of Radiologists Terms and Conditions

Figure 2 Anatomic drawing of the dorsum of the foot, illustrating the course of the flexor hallicus longus (FHL; large grey arrows) and flexor digitorum longus (FDL; black arrows). Note the lateral location of FHL relative to FDL and tibialis posterior (PT; white arrow) at the tarsal tunnel. FHL crosses dorsal to FHL at the master knot of Henry (circle) where the 2 tendons are encircled by a common tendon sheath). More distally, the FHL is located medial to FDL. Canadian Association of Radiologists Journal 2011 62, 154-157DOI: (10.1016/j.carj.2009.12.006) Copyright © 2011 Canadian Association of Radiologists Terms and Conditions