Delfaut Emmanuelle M, Demondion Xavier, Bieganski Anne, Thiron Marie-Camille, Mestdagh Henry, Cotten Anne
Department of Skeletal Radiology, Roger Salengro Hospital, CHRU of Lille, Bd du Professeur Jules Leclercq, 59037 Lille Cedex, France.
Radiographics. 2003 May-Jun;23(3):613-23. doi: 10.1148/rg.233025053.
Nerve entrapment at the foot and ankle involves thin and complex anatomic structures and is underdiagnosed because clinical symptoms and electrophysiologic findings may not contribute to the diagnosis. Nerve entrapment can be secondary to acute trauma or repetitive microtrauma. The latter often results from intensive sports-related activity, inappropriate footwear, or internal foot derangement. Various lesions that occur in fibro-osseous tunnels can cause nerve compression (eg, ganglion cysts, varicosities, bone and joint abnormalities, tumors, tenosynovitis, supernumerary or hypertrophic muscles). Accurate nerve examination must be performed, particularly in patients with atypical ankle pain, to detect focal tenderness or paresthesia. Ultrasonography is useful in this setting because it yields both clinical and morphologic findings. High-resolution magnetic resonance imaging provides accurate delineation of the nervous system anatomy. Furthermore, technologic developments in the field of radiology are making it possible to obtain clearer, more accurate images. Radiologists must be aware of the main nerve entrapment syndromes at the foot and ankle and be able to perform accurate nerve examinations with different imaging modalities in patients with foot and ankle pain.
足部和踝关节的神经卡压涉及纤细且复杂的解剖结构，且常被漏诊，因为临床症状和电生理检查结果可能无助于诊断。神经卡压可能继发于急性创伤或重复性微创伤。后者通常源于高强度的体育相关活动、不合适的鞋类或足部内部紊乱。纤维骨性通道中发生的各种病变可导致神经受压（如腱鞘囊肿、静脉曲张、骨与关节异常、肿瘤、腱鞘炎、多余或肥大的肌肉）。必须进行准确的神经检查，尤其是对于有非典型踝关节疼痛的患者，以检测局部压痛或感觉异常。超声检查在这种情况下很有用，因为它能提供临床和形态学检查结果。高分辨率磁共振成像能准确描绘神经系统解剖结构。此外，放射学领域的技术发展使得获取更清晰、更准确的图像成为可能。放射科医生必须了解足部和踝关节主要的神经卡压综合征，并能够对有足部和踝关节疼痛的患者使用不同的成像方式进行准确的神经检查。
