Tarsal Tunnel Syndrome Due to Varicose Vascular Structures: A Case Report
Journal Title: Radiology – Open Journal - Year 2016, Vol 1, Issue 1
Abstract
Objective: We report a case of a tarsal tunnel syndrome caused by a varicose vascular structures identified by foot MRI. Case report: An eighty-year old male came to our attention for a chronic intermittent bilateral plantar numbness. Symptoms were evident especially in the left foot when taking a bath or after a long distance walk. Feet were bilaterally flat. Ankles range of motion was bilaterally complete and pain free. Resisted range of motion testing including resisted ankle dorsiflexion, plantar flexion, inversion, and eversion was found to be pain free and of equal strength bilaterally. Neurological testing of the lower extremities was found to be positive for the Tinel sign at level of medial malleolus. Left ankle MRI showed evidence of several varicose vascular structures. One of the varicose vascular structures was suddenly narrow at level of tarsal tunnel. Posterior tibial vein at the tarsal tunnel level was dilated and appeared to continue in the varicose vascular structure on contrast study. Diagnosis of tarsal tunnel syndrome was made both by symptoms and imaging, considering the dilatation of the posterior tibial vein and the compression of the varicose structures around the tarsal tunnel. Treatment: Resection surgery of the retinaculum was performed in order to decrease the pressure on the tarsal tunnel. The patient’s symptom reduced after the surgery. However, a few months later he referred recurrence of plantar numbness. Conclusion: Patients who suffer from tarsal tunnel syndrome caused by a varicose vascular structures can show different symptoms if compared with those present in the same syndrome caused by other diseases. If varicose veins are detected in the tarsal tunnel and symptoms of compression are present, along with a concomitant foot deformity that predisposes to disease, diagnosis of tarsal tunnel syndrome should be considered. In order to achieve good results, the treatment of the varicose vascular structures and the correction of foot deformities are recommended together with a tarsal tunnel decompression.
Authors and Affiliations
Yuko Kobashi
Keywords
Related Articles
- EP ID EP554173
- DOI 10.17140/ROJ-1-103
- Views 126
- Downloads 0
Cerebral Blood Flow Assessment by Digital Subtraction Angiography
Cerebral vascular disease is responsible for nearly 800 000 hospital admissions annually with a total healthcare cost of $34 billion. Neuro-interventional surgery is at the forefront of fast-response assessment and inter...
On the Destruction of Cancer Cells Using Laser-Induced Shock Waves: A Review on Experiments and Multiscale Computer Simulations
In the clinical treatment of solid tumors, besides traditional surgery and chemotherapy, the use of High Intensity Focused Ultrasound (HIFU) has been established as a minimally non-invasive technique for tumor treatment,...
MRI Investigation of Optic Radiations in Human Brain: New Findings and Technical Considerations
Optic Radiations (ORs) are two white matter fiber bundles allowing direct connection between homolateral Lateral Geniculate Nucleus (LGN) and visual cortex. From the anatomical point of view, ORs are conventionally divid...
Bio-Mathematical Modelling in Tumor Evaluation Via Magnetic Resonance Imaging
In the last 25 years, within the field of tumor evaluation using magnetic resonance imaging (MRI), 2 main promising applications have emerged that can provide useful functional information beyond the morphological images...
Update on Limbic Connections in Human Brain: A Possible Closer Relationship Between Brain Processes and Visceral Information
The limbic system includes cortical and subcortical brain structures involved in several functions, first of all emotional and memory processes and integration. Two key structures of the limbic network are hippocampus an...