Tarsal Tunnel Syndrome
Tibial Nerve
Electrodiagnosis
Carpal Tunnel Syndrome
Neural Conduction
Cubital Tunnel Syndrome
Foot
Tarsal tunnel syndrome caused by ganglia. (1/24)
We describe in 30 feet the occurrence of a tarsal tunnel syndrome caused by a ganglion. The presenting symptom was numbness or pain in the toes and the sole with paraesthesiae in the distribution of the medial plantar nerve in 63% of the patients. Swellings which were not palpable were detected by ultrasonography. Twenty-nine patients were treated by operation. Most ganglia originated from the talocalcaneal joint, and five were associated with a talocalcaneal coalition. The surgical outcome was satisfactory in all patients except one who had a further operation for a recurrence of the ganglion. (+info)Neurovascular decompression for idiopathic tarsal tunnel syndrome: technical note. (2/24)
OBJECTIVE: The surgical outcome of idiopathic tarsal tunnel syndrome (TTS) is reported to be worse than that attributable to ganglion, tarsal coalition, or tumour, and therefore further development in the surgical treatment for idiopathic TTS is considered to be necessary. Here the efficacy of neurovascular decompression for patients with idiopathic TTS is evaluated. METHODS: Twelve feet from nine patients with idiopathic TTS were treated. The patients were aged 52-78 years (mean 64.6 years), and all of them complained of pain or dysaesthesia of the sole of the foot. The posterior tibial nerve was freed from the attached arteriovenous complex (posterior tibial artery and veins). The dissected nerve had a flattened appearance in all of the patients, suggesting nerve compression by the adjacent arteriovenous complex and superficially by the flexor retinaculum. A graft of fat was inserted as both a cushion and an antiadhesive between the vessels and the nerve to achieve neurovascular decompression. RESULTS: Patients on whom neurovascular decompression was performed had resolution or lessening of symptoms in their feet. Neither wound infection nor recurrence of symptoms was found during the follow up period (mean 26.8 months). CONCLUSION: Neurovascular compression syndrome plays a part in idiopathic TTS, and adding neurovascular decompression to resection of the flexor retinaculum is effective. (+info)Tarsal tunnel syndrome - the effect of the associated features on outcome of surgery. (3/24)
Between 1989 and 2000, 16 patients underwent surgery for tarsal tunnel syndrome; 12 patients (13 feet) were available for follow-up at a mean of 83 (12-143) months. The symptoms had resolved in six feet, were improved in four, were unchanged in two and recurred after five years in one. Better results are obtained in patients who have space occupying lesions than in those in whom the aetiology is idiopathic or post-traumatic or those with foot deformities. (+info)The tarsal tunnel syndrome after a proximal lesion. (4/24)
Three patients in whom the first symptoms of the tarsal tunnel syndrome (TTS) emerged after an acute event proximal to but not affecting the ankle are described. These patients suggest that a pre-existing asymptomatic TTS may become manifest after a mechanism akin to that described in the "double crush" syndrome. (+info)Diagnosing heel pain in adults. (5/24)
Heel pain is a common condition in adults that may cause significant discomfort and disability. A variety of soft tissue, osseous, and systemic disorders can cause heel pain. Narrowing the differential diagnosis begins with a history and physical examination of the lower extremity to pinpoint the anatomic origin of the heel pain. The most common cause of heel pain in adults is plantar fasciitis. Patients with plantar fasciitis report increased heel pain with their first steps in the morning or when they stand up after prolonged sitting. Tenderness at the calcaneal tuberosity usually is apparent on examination and is increased with passive dorsiflexion of the toes. Tendonitis also may cause heel pain. Achilles tendonitis is associated with posterior heel pain. Bursae adjacent to the Achilles tendon insertion may become inflamed and cause pain. Calcaneal stress fractures are more likely to occur in athletes who participate in sports that require running and jumping. Patients with plantar heel pain accompanied by tingling, burning, or numbness may have tarsal tunnel syndrome. Heel pad atrophy may present with diffuse plantar heel pain, especially in patients who are older and obese. Less common causes of heel pain, which should be considered when symptoms are prolonged or unexplained, include osteomyelitis, bony abnormalities (such as calcaneal stress fracture), or tumor. Heel pain rarely is a presenting symptom in patients with systemic illnesses, but the latter may be a factor in persons with bilateral heel pain, pain in other joints, or known inflammatory arthritis conditions. (+info)Ultrasonography in tarsal tunnel syndrome. (6/24)
OBJECTIVE: The purpose of this study was to clarify the diagnostic value of ultrasonography in tarsal tunnel syndrome. METHODS: Seventeen patients (17 feet) with tarsal tunnel syndrome were treated between 1988 and 2003. Preoperative ultrasonography was performed, and the cause of the syndrome was confirmed intraoperatively in all cases. Long and short axes of the tarsal tunnel were scanned to ascertain the presence of any space-occupying lesion. RESULTS: The causes of tarsal tunnel syndrome, as confirmed by surgery, were ganglia (n = 10), talocalcaneal coalition (n = 1), talocalcaneal coalition associated with ganglia (n = 3), and varicose veins (n = 3). Among the cases involving ganglia, hypoechoic or anechoic regions were observed. The mean sizes +/- SD of these regions were 19.4 +/- 8.8 mm in the long axis, 15.2 +/- 6.3 mm in the short axis, and 10.4 +/- 3.8 mm in depth. Of these, 3 ganglia were not clearly palpable before surgery and were small: 10 x 10 x 7, 13 x 11 x 9, and 9 x 8 x 7 mm. Among the cases involving talocalcaneal coalition, ultrasonography indicated a beak-shaped bony process on the short axis images. Although these 3 cases were associated with ganglia, this could not be determined by preoperative palpation. CONCLUSIONS: As a diagnostic imaging technique for tarsal tunnel syndrome, ultrasonography is extremely useful for identifying space-occupying lesions. Ultrasonography should be performed routinely in patients with suspected tarsal tunnel syndrome. (+info)Anterior tarsal tunnel syndrome. (7/24)
We have reviewed 10 patients treated for anterior tarsal tunnel syndrome produced by compression of the deep peroneal nerve or its branches, and we have studied the anatomy of the tunnel in 25 adult feet. The causes of onset of the syndrome included contusion of the dorsum of the foot, tight shoe laces, talonavicular osteophytosis, ganglion, and pes cavus. The clinical signs were often diagnostic but electromyography was helpful. Operative decompression in nine feet of eight patients gave successful results at 1.5 to 4 years follow-up. (+info)Tarsal tunnel syndrome caused by a talocalcaneal joint amyloidoma in a long-term haemodialysis patient: a case report. (8/24)
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. (+info)Tarsal Tunnel Syndrome (TTS) is a compressive neuropathy of the tibial nerve as it passes through the tarsal tunnel, a fibro-osseous canal formed by the medial malleolus and the talus bones on the inner ankle. The tibial nerve and its branches provide sensory innervation to the sole of the foot and motor function to several muscles in the lower leg and foot.
In TTS, increased pressure or compression within the tarsal tunnel leads to entrapment of the tibial nerve or its branches, resulting in pain, numbness, tingling, or burning sensations along the distribution of the affected nerves. Common causes include space-occupying lesions (e.g., ganglion cysts, varicosities), trauma, tenosynovitis, or systemic conditions like diabetes and rheumatoid arthritis.
Diagnosis typically involves a thorough clinical examination, including the patient's history, physical examination, and specialized tests such as nerve conduction studies and electromyography (EMG). Treatment options may include conservative measures like immobilization, orthotics, nonsteroidal anti-inflammatory drugs (NSAIDs), or corticosteroid injections. In severe cases or when conservative treatments fail, surgical decompression of the tarsal tunnel might be necessary to alleviate symptoms and prevent further nerve damage.
The Tibial nerve is a major branch of the sciatic nerve that originates in the lower back and runs through the buttock and leg. It provides motor (nerve impulses that control muscle movement) and sensory (nerve impulses that convey information about touch, temperature, and pain) innervation to several muscles and skin regions in the lower limb.
More specifically, the Tibial nerve supplies the following structures:
1. Motor Innervation: The Tibial nerve provides motor innervation to the muscles in the back of the leg (posterior compartment), including the calf muscles (gastrocnemius and soleus) and the small muscles in the foot (intrinsic muscles). These muscles are responsible for plantarflexion (pointing the foot downward) and inversion (turning the foot inward) of the foot.
2. Sensory Innervation: The Tibial nerve provides sensory innervation to the skin on the sole of the foot, as well as the heel and some parts of the lower leg.
The Tibial nerve travels down the leg, passing behind the knee and through the calf, where it eventually joins with the common fibular (peroneal) nerve to form the tibial-fibular trunk. This trunk then divides into several smaller nerves that innervate the foot's intrinsic muscles and skin.
Damage or injury to the Tibial nerve can result in various symptoms, such as weakness or paralysis of the calf and foot muscles, numbness or tingling sensations in the sole of the foot, and difficulty walking or standing on tiptoes.
Electrodiagnosis, also known as electromyography (EMG), is a medical diagnostic procedure that evaluates the health and function of muscles and nerves. It measures the electrical activity of skeletal muscles at rest and during contraction, as well as the conduction of electrical signals along nerves.
The test involves inserting a thin needle electrode into the muscle to record its electrical activity. The physician will ask the patient to contract and relax the muscle while the electrical activity is recorded. The resulting data can help diagnose various neuromuscular disorders, such as nerve damage or muscle diseases, by identifying abnormalities in the electrical signals.
Electrodiagnosis can be used to diagnose conditions such as carpal tunnel syndrome, peripheral neuropathy, muscular dystrophy, and amyotrophic lateral sclerosis (ALS), among others. It is a valuable tool in the diagnosis and management of neuromuscular disorders, helping physicians to develop appropriate treatment plans for their patients.
Carpal Tunnel Syndrome (CTS) is a common peripheral nerve disorder that affects the median nerve, which runs from the forearm into the hand through a narrow tunnel-like structure in the wrist called the carpal tunnel. The condition is caused by compression or pinching of the median nerve as it passes through this tunnel, leading to various symptoms such as numbness, tingling, and weakness in the hand and fingers.
The median nerve provides sensation to the thumb, index finger, middle finger, and half of the ring finger. It also controls some small muscles in the hand that allow for fine motor movements. When the median nerve is compressed or damaged due to CTS, it can result in a range of symptoms including:
1. Numbness, tingling, or burning sensations in the fingers (especially the thumb, index finger, middle finger, and half of the ring finger)
2. Pain or discomfort in the hand, wrist, or forearm
3. Weakness in the hand, leading to difficulty gripping objects or making a fist
4. A sensation of swelling or inflammation in the fingers, even if there is no visible swelling present
5. Nighttime symptoms that may disrupt sleep patterns
The exact cause of Carpal Tunnel Syndrome can vary from person to person, but some common risk factors include:
1. Repetitive hand and wrist motions (such as typing, writing, or using tools)
2. Prolonged exposure to vibrations (from machinery or power tools)
3. Wrist trauma or fractures
4. Pregnancy and hormonal changes
5. Certain medical conditions like diabetes, rheumatoid arthritis, and thyroid disorders
6. Obesity
7. Smoking
Diagnosis of Carpal Tunnel Syndrome typically involves a physical examination, medical history review, and sometimes specialized tests like nerve conduction studies or electromyography to confirm the diagnosis and assess the severity of the condition. Treatment options may include splinting, medication, corticosteroid injections, and in severe cases, surgery to relieve pressure on the median nerve.
Neural conduction is the process by which electrical signals, known as action potentials, are transmitted along the axon of a neuron (nerve cell) to transmit information between different parts of the nervous system. This electrical impulse is generated by the movement of ions across the neuronal membrane, and it propagates down the length of the axon until it reaches the synapse, where it can then stimulate the release of neurotransmitters to communicate with other neurons or target cells. The speed of neural conduction can vary depending on factors such as the diameter of the axon, the presence of myelin sheaths (which act as insulation and allow for faster conduction), and the temperature of the environment.
Cubital Tunnel Syndrome is a medical condition that affects the ulnar nerve, which runs down the arm and through a narrow tunnel inside the elbow, also known as the cubital tunnel. When this nerve becomes compressed or irritated in this area, it can lead to various symptoms such as numbness, tingling, and pain in the ring and little fingers, as well as weakness in the hand and forearm.
The condition is often caused by repetitive motion or prolonged pressure on the elbow, such as from leaning on the arm or bending the elbow for extended periods of time. In some cases, it may also be due to bone spurs, cysts, or other abnormalities that narrow the cubital tunnel and put pressure on the ulnar nerve.
Treatment for Cubital Tunnel Syndrome typically involves avoiding activities that aggravate the condition, wearing a splint or brace to keep the elbow straight during sleep, and taking anti-inflammatory medications to reduce swelling and pain. In more severe cases, surgery may be necessary to relieve pressure on the ulnar nerve and alleviate symptoms.
In medical terms, toes are the digits located at the end of the foot. Humans typically have five toes on each foot, consisting of the big toe (hallux), second toe, third toe, fourth toe, and little toe (fifth toe). The bones of the toes are called phalanges, with the exception of the big toe, which has a different bone structure and is composed of a proximal phalanx, distal phalanx, and sometimes a sesamoid bone.
Toes play an essential role in maintaining balance and assisting in locomotion by helping to push off the ground during walking or running. They also contribute to the overall stability and posture of the body. Various medical conditions can affect toes, such as ingrown toenails, bunions, hammertoes, and neuromas, which may require specific treatments or interventions to alleviate pain, restore function, or improve appearance.
In medical terms, the foot is the part of the lower limb that is distal to the leg and below the ankle, extending from the tarsus to the toes. It is primarily responsible for supporting body weight and facilitating movement through push-off during walking or running. The foot is a complex structure made up of 26 bones, 33 joints, and numerous muscles, tendons, ligaments, and nerves that work together to provide stability, balance, and flexibility. It can be divided into three main parts: the hindfoot, which contains the talus and calcaneus (heel) bones; the midfoot, which includes the navicular, cuboid, and cuneiform bones; and the forefoot, which consists of the metatarsals and phalanges that form the toes.
Medical professionals define "flatfoot" or "pes planus" as a postural deformity in which the arch of the foot collapses, leading to the entire sole of the foot coming into complete or near-complete contact with the ground. This condition can be classified as flexible (the arch reappears when the foot is not bearing weight) or rigid (the arch does not reappear). Flatfoot can result from various factors such as genetics, injury, aging, or certain medical conditions like rheumatoid arthritis and cerebral palsy. In some cases, flatfoot may not cause any symptoms or problems; however, in other instances, it can lead to pain, discomfort, or difficulty walking. Treatment options for flatfoot depend on the severity of the condition and associated symptoms and may include physical therapy, orthotics, bracing, or surgery.
Tarsal tunnel syndrome
Philip Radovic
Sinus tarsi syndrome
List of anatomy mnemonics
Tarsal tunnel
Cuboid syndrome
Antalgic gait
Shin Joong Oh
Flexor retinaculum of foot
Tinel's sign
Burning feet syndrome
Stewart Faulkner
List of diseases (T)
List of ICD-9 codes 320-389: diseases of the nervous system and sense organs
Plantar fasciitis
Nerve conduction study
Peripheral nervous system
Alexa Szvitacs
List of disorders of foot and ankle
Tarsus (skeleton)
George Goodheart
Foot and ankle surgery
TTS
List of diseases (C)
List of syndromes
List of MeSH codes (C10)
List of neurological conditions and disorders
List of neuromuscular disorders
Magnetic resonance neurography
Flexor digitorum longus muscle
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