Department of Medical Imaging, St. Joseph's Health Care London, Ontario, Canada.
Department of Diagnostic Radiology, University of Manitoba, St. Boniface General Hospital, Canada.
J Musculoskelet Neuronal Interact. 2024 Dec 1;24(4):433-438.
Anterior tarsal tunnel syndrome, an infrequent entrapment neuropathy involving the deep peroneal nerve beneath the inferior extensor retinaculum in the anterior ankle, is often overlooked on medical images, leading to delayed diagnosis and treatment. We present the case of a 52-year-old male, an avid runner, who exhibited a sensation of burning and tingling in the dorsal region of both feet. Electrophysiologic studies suggested bilateral deep peroneal neuropathy. Subsequent magnetic resonance imaging revealed bilateral focal regions of signal alteration, consistent with scarring, encasing the deep peroneal nerves at the anterior tarsal tunnel. These regions were indented by the deep laminae of the inferior extensor retinacula, suggesting compression. The constellation of findings was consistent with anterior tarsal tunnel syndrome. This is a unique case of bilateral deep peroneal nerve entrapment exacerbated by repetitive microtrauma, culminating in anterior tarsal tunnel syndrome. Notably, this case represents the first instance in literature where MRI played a pivotal role in diagnosis.
跗管综合征是一种不常见的神经卡压综合征，涉及到内踝前方的伸肌支持带下方的腓深神经，在医学影像上经常被忽视，导致诊断和治疗的延误。我们报告了一例 52 岁男性患者，他是一位狂热的跑步者，表现为双脚背部烧灼感和刺痛感。电生理研究提示双侧腓深神经病变。随后的磁共振成像显示双侧存在信号改变的局灶性区域，符合瘢痕形成，包绕跗管内的腓深神经。这些区域被伸肌支持带的深层纤维束压迹，提示受压。这些发现与跗管综合征一致。这是一个独特的双侧腓深神经卡压病例，由反复微创伤加重，最终导致跗管综合征。值得注意的是，本例是文献中首例 MRI 在诊断中发挥关键作用的病例。
