1/5. Anterior tarsal tunnel syndrome: case report.Anterior tarsal tunnel syndrome is a rare entrapment neuropathy involving the deep peroneal nerve beneath the inferior extensor retinaculum of the ankle and foot. This syndrome may be a clinically under-recognized entity, thus making a missed diagnosis and delayed treatment likely. We present the case of a 53-year-old woman who for many years had experienced the clinical symptoms of anterior tarsal tunnel syndrome, including pain in the dorsum of the right foot with numbness radiating to the first web space. Roentgenograms of the foot revealed osteophytes on the dorsum of the talus as it articulated with the navicular bone. During surgery, the osteophytes were found to be irritating the deep peroneal nerve. After surgical decompression of the anterior tarsal tunnel, the patient had a significant reduction of symptoms. One year later, she was noted to be asymptomatic with normal physical findings. We believe that this case points to the necessity of more thoughtful attention to this syndrome and its diagnosis. That is to say, a thorough knowledge of the pathogenesis and a comprehensive physical examination are the prerequisites for correct diagnosis and appropriate treatment.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/5. fibromyalgia and Tinel's sign in the foot.In the physical examination of the patient suspected of having tarsal tunnel syndrome, the podiatric physician relies on Tinel's sign: tapping the posterior tibial nerve in the tarsal tunnel should produce a distally radiating sensation if the nerve is pathologically compressed at this location. The American College of rheumatology recognizes fibromyalgia as a condition characterized by multiple "tender points" on physical examination. This report compares the locations of the 18 critical diagnostic fibromyalgia points with known sites of anatomical entrapment of peripheral nerves in the lower extremity. We also describe a patient with both fibromyalgia and tarsal tunnel syndrome. Tinel's sign in the lower extremity is a valid technique for assessing peripheral nerve compression in the patient with fibromyalgia.- - - - - - - - - - ranking = 1.9025226668832keywords = physical examination, physical (Clic here for more details about this article) |
3/5. tarsal tunnel syndrome secondary to neurilemmoma.neurilemmoma is an uncommon cause of tarsal tunnel syndrome, and no other cases of this disorder secondary to a lesion at the bifurcation of the medial and lateral plantar nerves have been described. In this case, a 2 x 0.5 x 1-cm mass was palpable on physical examination, and, after failed conservative treatment, surgical excision brought prompt relief of symptoms.- - - - - - - - - - ranking = 0.9512613334416keywords = physical examination, physical (Clic here for more details about this article) |
4/5. Nerve entrapment of the foot and ankle in runners.In the 10 years 1972 through 1982, the senior author performed 21 operations on 15 runners with persistent foot and ankle pain. The operative procedures involved decompression of peripheral nerves in the foot and ankle, consisting of release of soft tissues in the tarsal tunnel and foot or removal of abnormal bony excrescences that were irritating these nerves. All 15 runners had good to excellent results and all returned to their preinjury running status, including the competitive athletes. foot and ankle pain is best treated conservatively, but when signs and symptoms culled from a careful history and physical examination reflect a nerve entrapment syndrome, surgical intervention has its place in the armamentarium of the surgeon.- - - - - - - - - - ranking = 0.9512613334416keywords = physical examination, physical (Clic here for more details about this article) |
5/5. The tarsal tunnel syndrome.tarsal tunnel syndrome is relatively rare and the diagnosis may be difficult even though the etiologies for the syndrome are multiple. The symptoms are often vague but are usually burning pain and paresthesias in the toes and soles of the feet with nocturnal exacerbations. The physical examination may elicit a sensory deficit over the cutaneous distribution of the median and/or lateral plantar nerve. There may also be tenderness over the flexor retinaculum. electrodiagnosis, especially with the addition of the orthodromic compound nerve action potential latency technique, is essential to confirm the diagnosis. The findings may be confined to the distribution of either the medial or lateral plantar nerves and, thus, both distal latencies must be determined. Surgical decompression of the tarsal tunnel has usually proven to be helpful in those patients who do not respond to conservative treatment.- - - - - - - - - - ranking = 0.9512613334416keywords = physical examination, physical (Clic here for more details about this article) |