van Zantvoort Aniek Pm, Cuppen Paul, Scheltinga Marc R
Department of Surgery, Máxima Medisch Centrum, Veldhoven, Noord Brabant, The Netherlands.
Department of Musculoskeletal Medicine, Cheiron Medisch Centrum Waalre, Waalre, Noord Brabant, The Netherlands.
BMJ Case Rep. 2017 Oct 4;2017:bcr-2017-220704. doi: 10.1136/bcr-2017-220704.
The differential diagnosis of exercise-induced lower leg pain in young individuals is extensive and includes entities such as chronic exertional compartment syndrome, popliteal arterial entrapment syndrome, cystic adventitial disease, medial tibial stress syndrome and tibial stress fractures. Peripheral nerve-related lower leg pain syndromes are unusual. We present a 41-year-old woman who was diagnosed with an ancient schwannoma of the right common peroneal nerve (CPN) as a rare cause of lower leg pain. This case report provides simple diagnostic bedside tools that may be used to diagnose CPN abnormalities. Altered lateral lower leg skin sensation was found using a simple cotton swab, whereas a nodule was palpated at the fibular head. A positive Tinel sign indicated CPN dysfunction. MRI confirmed the diagnosis. Surgical resection is simple and curative.
年轻个体运动引起的小腿疼痛的鉴别诊断范围广泛，包括慢性运动性骨筋膜室综合征、腘动脉压迫综合征、囊性外膜病、胫骨内侧应力综合征和胫骨应力性骨折等疾病。与周围神经相关的小腿疼痛综合征并不常见。我们报告一例41岁女性，其被诊断为右侧腓总神经陈旧性神经鞘瘤，这是导致小腿疼痛的罕见原因。本病例报告提供了可用于诊断腓总神经异常的简单床边诊断工具。使用简单的棉棒可发现小腿外侧皮肤感觉改变，而在腓骨头处可触及一个结节。阳性Tinel征提示腓总神经功能障碍。MRI证实了诊断。手术切除简单且可治愈。
