Der N. suralis als beitragender Faktor für eine chronische Achillodynie

Abstract

BACKGROUND: Achillodynia is often seen as a sign of repetitive strain of dorsal tissue of the calf. A neurogene component is also considered for this disease pattern. This association has not yet been investigated. OBJECTIVE: The major goal of this study was the investigation of the dynamics of the sural nerve by ultrasonography with regard to movements of ankle, knee and hip. This concerns the physiological situation and pathological aspects of achillodynia. METHOD: In this cross-sectional study without a blinding-assay 29 sural nerves of 15 healthy subjects (group A) and 6 sural nerves of 3 subjects with pain or dysaesthesia at the achilles tendon or the lateral foot (group B) were investigated by diagnostic ultrasonography. RESULTS: The sural nerve had an average size of 3.7 mm 2 (± 0.05 mm 2 ) in healthy subjects and 4.1 mm 2 (± 0.1 mm 2 ) in those with achillodynia. The lateral (Mlat = 3.89 mm) and anterio-posterior (Map = 0.56 mm) movement of the sural nerve showed a statistic significantly greater extent by the whole range of motion of dorsalflexion and plantarflexion than by flexion and extension of the kneejoint (Mlat: p = 0.008; Map: p = 0.0115) or by abduction and adduction of the hipjoint (Mlat: p = 0.0025; Map: p = 0.002) for group A. Within this study no statistic significant differences between both groups could be observed regarding the dynamics and concerning the size of the sural nerve. CONCLUSION: The sural nerve shows a significantly higher range of motion in transverse direction in foot movement than in knee flexion and extension as well as hip joint abduction and adduction.