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 136
- Downloads 0
Evaluation of Whole Body DiffusionWeighted Imaging in the Staging and Treatment Response of Lymphoma Compared With Fluoride-Oxyglucose (FDG) PET/CT as a Reference Standard
Introduction: Positron emission tomography/computed tomography (PET/CT) is currently considered standard of practice for the management of lymphoma with sensitivity and specificity approaching 100%. However, it is expens...
Extrapleural Solitary Fibrous Tumor of Foot: A Case Report
A 77-year-old woman was admitted to our Hospital for a mass lesion in the plantar area of the left foot. The patient referred that the mass was present for about 30 years but it had never been treated before because asym...
Interoperability in Radiography Data: The Impossible Dream
Background: Technology in healthcare is changing at a very rapid pace. To ensure that technology is used efficiently to combat rising healthcare costs and new federal policies and laws, all technology must be able to com...
Two Case Reports of Angioleiomyoma of the Finger
Angioleiomyoma represents a benign stromal tumor, which usually occurs in the subcutaneous tissue of the extremities. The angioleiomyoma in the finger is rare. We report 2 rare cases of an angioleiomyoma in finger. Case...
The Impact of Industrialization on London Health
A new multidisciplinary project funded by the City of London Archaeological Trust (CoLAT) Rosemary Green grant will be using the latest imaging techniques on a large sample of archaeological skeletal assemblages from sev...