Instage1PTTD,the foot may have an unchanged appearance with no deformity.Pain and edema along the medial aspect of the rear foot corresponding to the posterior tibial tendon may be present.This is usually indicative of tenosynovitis or early tendinosis.Clinical assessment may demonstrate increased warmth,edema,and tenderness along the course of the tendon.Weakness is usually absent in stage 1 PTTD.