Case Of Tarsal Tunnel Syndrome Research Articles

Weight-bearing Ultrasound to Diagnose Talar Dislocation Causing Tarsal Tunnel Syndrome.

The neuropathic compression of the tibial nerve and/or its branches on the medial side of the ankle is called tarsal tunnel syndrome (TTS). Patients with TTS presents pain, paresthesia, hypoesthesia, hyperesthesia, muscle cramps or numbness which affects the sole of the foot, the heel, or both. The clinical diagnosis is challenging because of the fairly non-specific and several symptomatology. We demonstrate a case of TTS caused by medial dislocation of the talar bone on the calcaneus bone impacting the tibial nerve diagnosed only by ultrasound with the patient in the standing position.

Tarsal tunnel syndrome secondary to accessory or variant muscles: a clinical and anatomical systematic review.

Many etiologies are known to lead to a tarsal tunnel syndrome (TTS). One rare cause is mass-occupying lesions, and particularly accessory or variant muscles (AVM). This study aimed to systematically collect published clinical cases of TTS caused by AVM. An electronic literature search was conducted from inception to April 2021. The diagnosis of AVM should be reported in one of the following methods: ultrasonography, magnetic resonance imaging (MRI), or per-operatively. Data extraction included types and prevalence of accessory muscles, clinical presentation and diagnosis, and treatment modalities. Twenty-five studies were identified with a total 39 patients (47 ankles). The prevalence of TTS was reported in only two studies (9%). Forty-nine AVM were identified with the accessory flexor digitorum longus being the most common (52%). The most common sign/symptoms were tenderness (78.7%), pain (82.9%), dysesthesia (57.4%), Tinel sign (44.6%), and a swelling (25.5%). Decompression and excision were the most commonly performed procedures. Four accessory/variant muscles in the ankle have the potential to induce a tarsal tunnel syndrome. This review highlights the clinical and imagery specificities of TTS secondary to accessory or variant muscles. Mass-occupying etiology should be included in the list of differential diagnoses whenever a posterior tibial nerve compression is suspected.

A Rare Case of Flexor Digitorum Accessorius Longus Muscle Presenting as Tarsal Tunnel Syndrome.

Tarsal tunnel syndrome (TTS) is a relatively uncommon nerve entrapment neuropathy. Many pathologies are reported as possible causes for TTS. The diagnosis of TTS can be difficult and often missed. We present a rare case of TTS due to an accessory flexor digitorum longus muscle. Together with a high index of suspicion, MRI is the investigation of choice in making the diagnosis. These patients are best managed with excision or transposition of the flexor digitorum accessorius longus (FDAL) and neurolysis of the posterior tibial nerve and its branches.

Doppler Digest: Tarsal Tunnel Syndrome Secondary to Focal Posterior Tibial Vein Thrombosis

A compression of the posterior tibial nerve at the level of the tarsal tunnel, the so-called tarsal tunnel syndrome, most often arises secondary to scarring and fibrosis, tenosynovitis, or a mass effect of ganglion cysts and nerve sheath tumors. Most patients complain of a burning or stinging sensation in the foot sole, especially on plantar flexion and pronation of the foot. We report a case of tarsal tunnel syndrome, secondary to inflammation and edema of a localized thrombosis of the posterior tibial veins. We did not encounter any previous similar publications, but perhaps this could be an underreported comorbidity of deep venous thrombosis in the posterior tibial vein.

Analysis of Surgical Cases of Tarsal Tunnel Syndrome in Our Department: Case Series and Literature Review.

Background:Tarsal tunnel syndrome (TTS) is an entrapment neuropathy in which the tibial nerve is compressed within the tarsal tunnel and causes sensory disturbance in the sole of the foot. In this manuscript, we summarized our early surgical cases of TTS.Materials and Methods:Six feet in five patients with TTS were treated surgically. The patients were aged 31–70 years (mean 53.1 years), and all of them complained of pain or dysesthesia of the sole of the foot sparing the heel. Magnetic resonance imaging (MRI) and nerve conduction test were performed preoperatively. In surgery, flexor retinaculum was dissected (tarsal tunnel opening [TTO]), the posterior tibial nerve was freed from the arteriovenous complex (neurovascular decompression [NVD]), and fascia of the abductor hallucis muscle was excised to decompress the medial and lateral plantar nerve (releasing fascial of abductor hallucis muscle [RFAH]).Results:Preoperative MRI confirmed that all seven cases were idiopathic TTS. Moreover, NCD demonstrated delayed sensory conduction velocity but not delayed distal motor latency. Surgical decompression was beneficial in 5 feet. The recurrence of symptoms was found in one case within 1 postoperative month.Conclusion:Surgical treatment for idiopathic TTS with TTO, NVD, and RFAH was generally good. However, symptoms recurred in one instance. Some methods to prevent adhesion and granulation in the reconstructed tarsal tunnel should be considered.

Magnetic Resonance Imaging Conditions for Imaging of the Tarsal Tunnel

Tarsal tunnel syndrome(TTS)is an entrapment neuropathy of the posterior tibial nerve within the tarsal tunnel below the medial malleolus. An accurate diagnosis is difficult, and TTS is usually diagnosed from clinical symptoms due to the lack of accurate diagnostic tools. We aimed to standardize the diagnosis of TTS using MRI, and report the MRI conditions for clear visualization of the tarsal tunnel. We investigated which sequences and MRI conditions would be appropriate for the imaging of the tarsal tunnel in a healthy volunteer. As in routine brain MRI, the imaging time was within 15 minutes. We also performed an MRI study of the tarsal tunnel in two patients with TTS. Axial images obtained by fat-suppression 3-dimensional T2^*-weighted imaging(3D-T2^*WI)are the most useful for visualization of the tarsal tunnel. The axial images obtained by T2-weighted imaging(T2WI)and T1-weighted imaging(T1WI)were also useful for visualization of the area around the flexor retinaculum. The appropriate slice thickness was determined to be 1.5 mm, based on the resolution and photographic time. The flip angle, necessary for tissue resolution, was set at 15° because it provided the clearest image and highest contrast between different tissues. The total photographic time was within 14 minutes, and it is acceptable for routine MRI studies of TTS. In the two cases of TTS included in this study, the tarsal tunnel was clearly visible. For diagnosis of TTS using MRI, axial images obtained by fat-suppression 3D-T2^*WI, 2-dimensional(2D)-T2WI, and 2D-T1WI are recommended. A coronal image obtained by reconstruction of fat-suppression 3D-T2^*WI might be useful for anatomical understanding. In future studies, we plan to evaluate patients with TTS using the above protocol.

Bilateral tarsal tunnel syndrome attributed to bilateral fibrous tarsal coalition and symmetrical hypertrophy of the sustentaculum tali

Tarsal tunnel syndrome (TTS) is one of the frequently encountered entrapment neuropathies of the lower limb. Most often the aetiology is considered to be idiopathic. However, it has to be...

Classification system for flexor digitorum accessorius longus muscle variants within the leg: Clinical correlations

The flexor digitorum accessorius longus (FDAL), a variant leg muscle, can cause tarsal tunnel syndrome. This study was performed to classify the variants of the FDAL by dissection and to correlate the dissection results with clinical cases of tarsal tunnel syndrome caused by this muscle. Eighty lower limbs of embalmed Korean cadavers were dissected. MR images of two clinical cases of tarsal tunnel syndrome caused by the FDAL were correlated with the dissection results. The FDAL was observed in nine out of 80 specimens (11.3%) and it was classified into three types depending on its site of origin and its relationship to the posterior tibial neurovascular bundle (PTNV) in the leg. In Type I (6.3%), the FDAL originated in the leg and ran superficially along the PTNV, either not crossing (Type Ia, 3.8%) or crossing (Type Ib, 2.5%) the neurovascular bundle. In Type II (6.3%), it originated in the tarsal tunnel. Most FDALs followed a similar course in the tarsal tunnel and the plantar pedis. On correlating the MR images of the clinical cases with this classification, the FDAL corresponded to Types Ia and II. All three types of FDAL can compress the tibial nerve in the tarsal tunnel or the distal leg. Clarification of the topographical relationship between this muscle and the PTNV would help to improve the results of surgery for tarsal tunnel syndrome caused by the FDAL.

Tarsal tunnel syndrome caused by giant cell tumour of the tendon sheath: case report with review of the literature

Tarsal tunnel syndrome (TTS) is an uncommon entrapment neuropathy caused by the compression of the posterior tibial nerve and its branches in the tarsal tunnel. It is classified as a rare disease by the Office of Rare Diseases Research of the National Institutes of Health, as it affects 1 in 1,500 people. It has a marginally higher incidence rate (56 %) in women. The most common causes of TTS are trauma (17 %), varicosities (13 %), talipes varus (11 %), fibrosis (9 %) and talipes valgus (8 %). Twenty to forty percent of cases have no discernible cause [1]. A case of tarsal tunnel syndrome caused by a giant cell tumour of the tendon sheath is presented. This is followed by a review of the literature.

130. A unique case of tarsal tunnel syndrome in a competitive long distance swimmer

130. A unique case of tarsal tunnel syndrome in a competitive long distance swimmer

Poster 112 Unique Case of Tarsal Tunnel Syndrome in a Competitive Long-distance Swimmer: A Case Report

Poster 112 Unique Case of Tarsal Tunnel Syndrome in a Competitive Long-distance Swimmer: A Case Report

Focal conduction block in a case of tarsal tunnel syndrome

We report a case of tarsal tunnel syndrome (TTS) with focal conduction block across the tarsal tunnel (TT). A 46-year-old woman had pain in the left foot, sensory loss on the plantar surface, and positive Tinel sign over the TT. TTS was confirmed by magnetic resonance imaging (MRI) scan and surgery. Motor nerve conduction studies showed focal conduction block across the TT. Conduction block has rarely been reported in TTS. In this case, conduction block provides evidence for focal demyelination as the primary pathological process in TTS.

Magnetic Resonance Diagnosis of Tarsal Tunnel Syndrome Due to Flexor Digitorum Accessorius Longus and Peroneocalcaneus Internus Muscles

Anomalous muscles of the ankle are common. Although they are often asymptomatic, they can sometimes cause tarsal tunnel syndrome. We report a case of tarsal tunnel syndrome due to flexor digitorum accessorius longus and peroneocalcaneus internus muscles diagnosed on magnetic resonance imaging. Recognition of the most common accessory muscles of the ankle on magnetic resonance imaging and tarsal tunnel syndrome are also reviewed.

Neurilemmoma of the First Branch of the Lateral Plantar Nerve Causing Tarsal Tunnel Syndrome

In this article, the authors report a case of tarsal tunnel syndrome caused by neurilemmoma of the first branch of the lateral plantar nerve, with symptom resolved after excision. A 42-year-old man presented with left medial heel pain radiating to the lateral sole for 6 months. On examination, there was positive Tinel sign over the medial heel with pain radiating to the lateral sole. Ultrasonography and magnetic resonance imaging confirmed the presence of a 1-cm neurogenic tumor inside the tarsal tunnel. Intraoperatively, a 1-cm neurilemmoma was found at the first branch of the lateral plantar nerve inside the tarsal tunnel. The lesion was excised completely with preservation of its fascicle. The symptom resolved completely after the operation.

Sonography as an Aid to Neurophysiological Studies in Diagnosing Tarsal Tunnel Syndrome

Diagnosing tarsal tunnel syndrome can be difficult because of varying clinical diagnostic criteria and equivocal physical signs. We present a case of tarsal tunnel syndrome where nerve conduction identified distal tibial neuropathy and high-resolution sonography was able to show nerve swelling within the tarsal tunnel.

Varicosities as an Etiology of Tarsal Tunnel Syndrome and the Significance of Tinel’s Sign

Two cases of tarsal tunnel syndrome in two young men with surgical and radiologic details are reported. The role of varicosities as a cause of tarsal tunnel syndrome and the significance of Tinel's sign are discussed through a large review of the literature.

Le syndrome du canal tarsien par lipome compressif chez le sportif

ObjectiveTo report the diagnosis and the etiological context of tarsal tunnel syndrome and demonstrate the utility of surgery in the management of this syndrome.MethodsDescription of a case of tarsal tunnel syndrome caused by compressive lipoma in an athlete and the postoperative development of this syndrome.ResultsA 41-year-old ex-high-level female athlete complained of progressive paraesthesiae under the medial malleolus of her right foot, of five years’ duration. Clinical examination showed a mobile, painless mass in the same region. X-rays of the ankle revealed abnormalities in the soft tissue. Magnetic resonance imaging (MRI) showed swelling of the retromalleolar soft tissue. The diagnosis of lipoma was confirmed by histology. After surgery, the patient experienced partial improvement. Electromyography (EMG) was positive for posterior tibial nerve compression. MRI and ultrasound showed signs of postoperative fibrosis. After two infiltrations and medical treatment, moderate improvement was noted. The patient still describes some foot paraesthesiae nine months after surgery.ConclusionThe development of tarsal tunnel syndrome caused by compressive lipoma can be accelerated by a variety of factors, such as sporting activity. Both clinical examination and complementary investigations are useful in order to reach an accurate diagnosis. Failure of surgical decompression in our study points to fibrosis around the nerve or insufficient surgical excision.

Neurilemoma of the Posterior Tibial Nerve and Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is defined as a compressive neuropathy of the posterior tibial nerve in the tarsal canal. A neurilemoma is an uncommon, benign, encapsulated neoplasm derived from Schwann cells. We present a case of tarsal tunnel syndrome caused by this rare space-occupying lesion.

Tarsal Tunnel Syndrome Caused by a Talocalcaneal Joint Amyloidoma in a Long-Term Haemodialysis Patient: A Case Report

We present a case of tarsal tunnel syndrome caused by an amyloidoma arising from the talocalcaneal joint in a 64-year-old man with a long history of haemodialysis. He presented with numbness in the medial plantar area of the right foot without any antecedent trauma. The numbness was minimal at rest but gradually worsened, causing difficulty, when walking. Paraesthesia was present on the medial sole of the right foot. A positive Tinel-like sign was noted 2.5 cm below the medial malleolus. Magnetic resonance imaging demonstrated a round lesion, 1 cm in diameter, in the calcaneus, which was hypointense on T1-weighted images and hyperintense on T2-weighted images. In addition, a mass, 1 cm in diameter with a signal isointense to that of muscle was found adjacent to the talocalcaneal joint. The medial plantar nerve was decompressed after removing a solid, 1-cm diameter mass from the talocalcaneal joint. At 6 months post surgery, the numbness had completely resolved. No recurrence was observed at the 24-month follow-up.

Traumatic tarsal tunnel syndrome: the outcome of surgical decompression

A total of 26 cases of tarsal tunnel syndrome exclusively secondary to injury were treated by surgical decompression. Clinical diagnosis depends upon careful history and examination, with proximal and distal symptoms reproduced by direct compression of the posterior tibial nerve. Extensor hallucis longus weakness is a valuable sign demonstrating insufficiency of the posterior tibial nerve muscles that cannot stabilize the first metatarsal phalangeal joint. Immediate recovery of extensor hallucis longus power, the recovery of sensation and the lack of positive electrodiagnostic investigations suggest that the problem in the nerve is microvascular affecting pain fibres rather than myelinated nerve fibres. If symptoms persist longer than 6 months, we recommend surgical decompression, which, in our series, had a success rate of 80%.