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The four-tendon sign.

The three medial ankle tendons, from the anterior to posterior direction, can be remembered by using the mnemonic “Tom, Dick, and Harry.” The T in “Tom” is for the posterior tibial tendon (PTT); the D in “Dick,” for the flexor digitorum longus tendon; and the H in “Harry,” for the flexor hallucis longus tendon. A fourth tendinous structure will be seen at the medial ankle, located directly posterior to the medial malleolus, when the PTT is longitudinally split with separation of the components, giving the appearance of two separate tendons and a total of four medial ankle tendons.