Wu Wei-Ting, Özçakar Levent, Chang Ke-Vin
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 100006, Taiwan.
Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei 100006, Taiwan.
Diagnostics (Basel). 2024 Oct 11;14(20):2266. doi: 10.3390/diagnostics14202266.
A 27-year-old female presented with persistent right medial plantar pain that developed over six months following an ankle sprain. The pain, described as sharp and radiating to the toes, progressively worsened, affecting her ability to walk. An initial ultrasound examination suggested medial plantar nerve compression by a lipoma, prompting her referral for ultrasound-guided hydrodissection. During the pre-procedure assessment, sono-palpation (palpation using the ultrasound transducer) localized the pain to the Master Knot of Henry-where the medial plantar nerve, artery, and flexor tendons intersect. No lipoma but a normal fat pad was observed. Ultrasound-guided hydrodissection with 5% dextrose mixed with lidocaine and saline was performed. After two sessions, her pain significantly decreased, with her visual analogue scale score dropping from 8 to 5 after the first session and to 2 after the second, allowing her to resume normal activities. This case highlights the value of ultrasound in accurately diagnosing and treating conditions involving the Master Knot of Henry.
一名27岁女性因踝关节扭伤后六个月出现持续性右足底内侧疼痛前来就诊。疼痛呈锐痛，放射至脚趾，且逐渐加重，影响了她的行走能力。最初的超声检查提示脂肪瘤压迫足底内侧神经，促使她转诊接受超声引导下的水分离术。在术前评估中，超声触诊（使用超声探头进行触诊）将疼痛定位至亨利主结——足底内侧神经、动脉和屈肌腱交汇之处。未观察到脂肪瘤，仅见正常脂肪垫。遂行超声引导下5%葡萄糖与利多卡因及生理盐水混合的水分离术。经过两次治疗，她的疼痛显著减轻，视觉模拟评分在第一次治疗后从8分降至5分，第二次治疗后降至2分，使其能够恢复正常活动。该病例凸显了超声在准确诊断和治疗涉及亨利主结的病症中的价值。
