Sekiya H, Arai Y, Sugimoto N, Sasanuma H, Hoshino Y
Department of Orthopaedics, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan.
J Orthop Surg (Hong Kong). 2006 Dec;14(3):350-3. doi: 10.1177/230949900601400325.
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.
我们报告一例64岁长期血液透析男性患者，其跗管综合征由距跟关节处的淀粉样瘤引起。他表现为右足内侧足底区域麻木，无任何先前外伤史。休息时麻木轻微，但逐渐加重，行走时导致困难。右足底内侧存在感觉异常。在内踝下方2.5厘米处发现阳性类Tinel征。磁共振成像显示跟骨有一个直径1厘米的圆形病变，在T1加权图像上呈低信号，在T2加权图像上呈高信号。此外，在距跟关节附近发现一个直径1厘米、信号与肌肉等强度的肿块。从距跟关节切除一个直径1厘米的实性肿块后，对内侧足底神经进行了减压。术后6个月，麻木完全消失。在24个月的随访中未观察到复发。
