Fibromyalgia and Tinel’s Sign in the Foot

2004 ◽  
Vol 94 (4) ◽  
pp. 400-403 ◽  
Author(s):  
Linda Shookster ◽  
Gerald I. Falke ◽  
Ivica Ducic ◽  
Christopher T. Maloney ◽  
A. Lee Dellon
Keyword(s):  
Lower Extremity ◽  
Physical Examination ◽  
Peripheral Nerves ◽  
Tibial Nerve ◽  
Tarsal Tunnel ◽  
Tarsal Tunnel Syndrome ◽  
Tender Points ◽  
Posterior Tibial ◽  
American College Of Rheumatology ◽  
Tunnel Syndrome

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. (J Am Podiatr Med Assoc 94(4): 400–403, 2004)

Tarsal Tunnel Syndrome Caused by an Occult Schwannoma of the Posterior Tibial Nerve: Avoidance of Delay in Diagnosis

2021 ◽  
Vol 111 (1) ◽  
Author(s):  
Mehmet Burak Yalcin ◽  
Utku Erdem Ozer
Keyword(s):  
Peripheral Nerves ◽  
Tibial Nerve ◽  
Tarsal Tunnel ◽  
Posterior Tibial Nerve ◽  
Tarsal Tunnel Syndrome ◽  
Significant Delay ◽  
Delay In Diagnosis ◽  
Posterior Tibial ◽  
Entrapment Neuropathies ◽  
Tunnel Syndrome

Tarsal tunnel syndrome (TTS), resulting from compression of the posterior tibial nerve (PTN) within the tarsal tunnel, is a relatively uncommon entrapment neuropathy. Many cases of tarsal tunnel syndrome are idiopathic; however, some causes, including space-occupying lesions, may lead to occurrence of TTS symptoms. Schwannoma, the most common tumor of the sheath of peripheral nerves, is among these space-occupying lesions, and may cause TTS when it arises within the tarsal tunnel, and it may mimic TTS even when it is located outside the tarsal tunnel and cause a significant delay in diagnosis. The possibility of an occult space-occupying lesion compressing the PTN should be kept in mind in the differential diagnosis of TTS, and imaging studies that are usually not used in entrapment neuropathies may be of importance in such patients. This case report presents a 65-year-old woman with TTS symptoms and neurophysiologic findings secondary to an occult schwannoma of the PTN proximal to the tarsal tunnel. Avoidance of delay in diagnosis in secondary cases is emphasized.

scholarly journals Plexiform Neurofibroma of the Posterior Tibial Nerve Misdiagnosed as Proximal Tarsal Tunnel Syndrome: A Case Report

2018 ◽  
Vol 04 (01) ◽  
pp. e18-e22
Author(s):  
Sang Nam ◽  
Jung Kim ◽  
Jaeki Ahn ◽  
Yongbum Park
Keyword(s):  
Peripheral Nerves ◽  
Clinical Presentation ◽  
Tibial Nerve ◽  
Plexiform Neurofibroma ◽  
Benign Tumors ◽  
Medial Malleolus ◽  
Tarsal Tunnel ◽  
Tarsal Tunnel Syndrome ◽  
Posterior Tibial ◽  
Tunnel Syndrome

AbstractPlexiform neurofibromas of the foot are rare, benign tumors of the peripheral nerves. Diagnosis can be challenging if they present with symptoms mimicking other peripheral nerve pathologies. Tarsal tunnel syndrome is an entrapment syndrome of the entire tibial nerve behind the medial malleolus and under the flexor retinaculum. The clinical presentation typically includes posteromedial pain, positive Tinel's sign, and neurogenic signs, including both the sensation of numbness and the actual hypoesthesia and clawing of the toes.Here, we report the case of a 59-year-old female patient with plexiform neurofibroma with symptoms similar to those of tarsal tunnel syndrome. The plexiform neurofibroma was surgically excised and the nerve function was partially preserved.

Tarsal Tunnel Syndrome Associated with a Pulsating Artery

2010 ◽  
Vol 100 (3) ◽  
pp. 209-212 ◽  
Author(s):  
Eunkuk Kim ◽  
Martin K. Childers
Keyword(s):  
High Resolution ◽  
Ultrasound Imaging ◽  
Tibial Nerve ◽  
Tarsal Tunnel ◽  
Posterior Tibial Nerve ◽  
Tarsal Tunnel Syndrome ◽  
Ultrasound Guided ◽  
Nerve Ultrasound ◽  
Posterior Tibial ◽  
Tunnel Syndrome

We describe a patient with tarsal tunnel syndrome in whom ultrasound imaging revealed compression of the posterior tibial nerve by a pulsating artery. High-resolution ultrasound showed a round pulsating hypoechoic lesion in contact with the posterior tibial nerve. Ultrasound-guided injection of 0.5% lidocaine temporarily resolved the paresthesia. These findings suggest an arterial etiology of tarsal tunnel syndrome. (J Am Podiatr Med Assoc 100(3): 209–212, 2010)

Tibial Neuropathy—Tarsal Tunnel Syndrome

2018 ◽  
Author(s):  
Daniel A. Lyons ◽  
David L. Brown
Keyword(s):  
Physical Examination ◽  
Surgical Intervention ◽  
Tibial Nerve ◽  
Clinical History ◽  
Surgical Decompression ◽  
Tarsal Tunnel ◽  
Success Rates ◽  
Tarsal Tunnel Syndrome ◽  
Tunnel Syndrome ◽  
Space Occupying Lesion

Tarsal tunnel syndrome (TTS) is caused by compression of the tibial nerve and its branches within the tarsal tunnel at the ankle. The diagnosis of TTS is often made clinically, but imaging and electrodiagnostic studies should be considered when the diagnosis cannot be ascertained from the clinical history and physical examination. Surgical decompression of the tarsal tunnels should be pursued only after conservative measures have failed or when a space-occupying lesion or point of tibial nerve compression has been identified. Surgical intervention requires complete release of the flexor retinaculum at the medial ankle, as well as release of the three distinct tunnels enveloping the medial and lateral plantar nerves and the calcaneal branch. Success rates for tibial nerve decompression vary widely in the literature, ranging from 44% to 96%.

Tarsal Tunnel Syndrome and Additional Nerve Lesions in the Same Limb

Foot & Ankle ◽  
1993 ◽  
Vol 14 (2) ◽  
pp. 71-77 ◽  
Author(s):  
G. James Sammarco ◽  
David E. Chalk ◽  
John H. Feibel
Keyword(s):  
Diabetes Mellitus ◽  
Back Pain ◽  
Lower Extremity ◽  
Tarsal Tunnel ◽  
Tarsal Tunnel Syndrome ◽  
Previous Surgery ◽  
Posterior Tibial ◽  
Variable Success ◽  
Tunnel Syndrome ◽  
Variable Success Rate

Compression neuropathy in the lower extremity is common. The occurrence of more than one lesion of the nerve in the same limb is less frequent. Thirteen patients with 15 cases of tarsal tunnel syndrome associated with one or more additional lesions of the sciatic nerve or its branches of the same lower extremity are presented. Electrodiagnostic studies confirmed tarsal tunnel syndrome with conduction abnormalities at a number of lo cations along the sciatic, common peroneal, posterior tibial, or plantar nerves by mechanical impingement, met abolic axonal abnormality, or both. Seven of the 13 patients were treated with tarsal tunnel release. Six cases treated operatively improved significantly. Surgery on a previously operated foot or the existence of diabetes mellitus carried a fair prognosis. The association of back pain with or without previous surgery did not appear to affect the outcome of the tarsal tunnel release. No improvement in symptoms was apparent in the six unoperated patients during the period of the study. Multiple lesions of the nerves of a single extremity may account for the variable success rate of tarsal tunnel release.

scholarly journals Surgical Treatment of Tarsal Tunnel Syndrome - Case Report

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
EL Maqrout A ◽  
◽  
Fekhaoui MR ◽  
Boufettal M ◽  
Bassir RA ◽  
...  
Keyword(s):  
Tibial Nerve ◽  
Annular Ligament ◽  
Tarsal Tunnel ◽  
Posterior Tibial Nerve ◽  
Tarsal Tunnel Syndrome ◽  
Total Recovery ◽  
After Effects ◽  
Intensive Training ◽  
Posterior Tibial ◽  
Tunnel Syndrome

The first description of tarsal tunnel syndrome is recent. Koppel in 1960 evoked the after-effects of lesions of the posterior tibial nerve. Keck in 1969 was the first to describe compression of the posterior tibial nerve by the internal annular ligament. It was a young soldier who, after intensive training, had bilateral plantar anesthesia. The opening of the internal annular ligament had allowed a total recovery in 48 hours. Our objective here is to discuss the circumstances of the diagnosis of this syndrome, to analyze its anatomical and pathological causes, to present the types of treatments followed, in the light of the literature.

Extraskeletal Osteosarcoma: An Unusual Presentation as Tarsal Tunnel Syndrome

1995 ◽  
Vol 16 (12) ◽  
pp. 796-799 ◽  
Author(s):  
Kenneth A. Jaffe ◽  
Jeffrey D. Wade ◽  
F. Spencer Chivers ◽  
Gene P. Siegal
Keyword(s):  
Unusual Case ◽  
Benign Tumor ◽  
Tibial Nerve ◽  
Tarsal Tunnel ◽  
Posterior Tibial Nerve ◽  
Tarsal Tunnel Syndrome ◽  
Extraskeletal Osteosarcoma ◽  
Posterior Tibial ◽  
Compressive Neuropathy ◽  
Tunnel Syndrome

Tarsal tunnel syndrome is a compressive neuropathy caused by intrinsic or extrinsic pressure on the posterior tibial nerve or one of its terminal branches. A mass in association with tarsal tunnel syndrome is most likely a benign tumor or tumor-like condition, although a more malignant tumor must be in the differential diagnosis. We report an unusual case of an extraskeletal osteosarcoma causing tarsal tunnel syndrome.

Neurilemoma of the Posterior Tibial Nerve and Tarsal Tunnel Syndrome

2007 ◽  
Vol 97 (2) ◽  
pp. 148-150 ◽  
Author(s):  
Sarnarendra Miranpuri ◽  
Eric Snook ◽  
David Vang ◽  
Raymond M. Yong ◽  
William E. Chagares
Keyword(s):  
Schwann Cells ◽  
Tibial Nerve ◽  
Tarsal Tunnel ◽  
Posterior Tibial Nerve ◽  
Tarsal Tunnel Syndrome ◽  
Posterior Tibial ◽  
Compressive Neuropathy ◽  
Tunnel Syndrome ◽  
Tarsal Canal ◽  
Space Occupying Lesion

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. (J Am Podiatr Med Assoc 97(2): 148–150, 2007)

scholarly journals Posterior Tibial Nerve Schwannoma Presenting as Tarsal Tunnel Syndrome

Cureus ◽  
2019 ◽  
Author(s):  
Aaradhana J Jha ◽  
Chandan R Basetty ◽  
Gean C Viner ◽  
Chandler Tedder ◽  
Ashish Shah
Keyword(s):  
Tibial Nerve ◽  
Tarsal Tunnel ◽  
Posterior Tibial Nerve ◽  
Tarsal Tunnel Syndrome ◽  
Posterior Tibial ◽  
Tunnel Syndrome
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