Tarsal tunnel syndrome masked by painful diabetic polyneuropathy

International Journal of Surgery Case Reports
Tugrul OrmeciFikret Aysal

Abstract

Various causes influence the etiology of tarsal tunnel syndrome including systemic diseases with progressive neuropathy, such as diabetes. We describe a 52-year-old male patient with complaints of numbness, burning sensation and pain in both feet. The laboratory results showed that the patient had uncontrolled diabetes, and the EMG showed distal symmetrical sensory-motor neuropathy and nerve entrapment at the right. Ultrasonography and MRI showed the cyst in relation to medial plantar nerve, and edema- moderate atrophy were observed at the distal muscles of the foot. Foot neuropathy in diabetic patients is a complex process. So, in planning the initial treatment, medical or surgical therapy is selected based on the location and type of the pathology. Foot deformities can be corrected with resting, anti-inflammatory treatment, appropriate shoes, orthesis and socks, and if required, ankle stabilization can be attempted. If the patient is still unresponsive, surgical treatment may be applied. It is essential to investigate more localized reasons like tarsal tunnel syndrome that may mimic diabetic neuropathy, should be treated primarily.

References

Feb 1, 1979·Diabetes·D M FraserB F Clarke
Jun 19, 1998·Diabetic Medicine : a Journal of the British Diabetic Association·A J BoultonJ A Jervell
Dec 3, 1999·Foot & Ankle International·E TrepmanL Razzano
Feb 20, 2002·Clinical Imaging·M F LeeK S Yu
May 13, 2003·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Emmanuelle M DelfautAnne Cotten
Jul 16, 2010·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Andrea DonovanConrado F Cavalcanti
Jan 1, 2014·Muscle & Nerve·Benjamin S Boyd, Andrew Dilley

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