shadowtaya.blogg.se - Tarsal tunnel

Distal to the tunnel, the tibial nerve divides into the calcaneal sensory branches and the two plantar nerves, which are mixed nerves (contain both motor and sensory fibers). At the ankle, it runs posterior and inferior to the medial malleolus passing through a tunnel created by the flexor retinaculum. The tibial nerve is the continuation of the medial trunk of the sciatic nerve. If a nerve lesion localizes to the tarsal tunnel, the practitioner must determine the cause of the compression. Įlectromyography can be used to identify the specific muscles affected by a nerve lesion. A true entrapment from a thickened flexor retinaculum is rare. Other causes are posttraumatic fibrosis and acute trauma (such as those from sprains, strains, fractures) but can also result from lipomas, cysts, tumors, soft tissue infection, and inflammatory arthropathies. When this neuropathy occurs in the tarsal tunnel, it is known as tarsal tunnel syndrome. This condition is most frequently caused by external compression by ill-fitting footwear or tight plaster casts. Neuropathy of the posterior tibial nerve is a relatively rare condition that causes foot and ankle pain, paresthesia, and even weakness of the intrinsic foot muscles. Specifically, ENG and EMG are useful in identifying peripheral neuropathies caused by compression of the tibial nerve. Furthermore, many neuromuscular diagnoses cannot be identified on an MRI or CT scan and thus require an alternate modality to identify-this is the role of the electrodiagnosis techniques: Electroneurography (ENG) and electromyography (EMG). Often, it is difficult to fully elucidate a neuromuscular diagnosis with history and physical examination alone. Discuss the importance of communicating the findings of the electrophysiological study with the interprofessional team to better enhance patient outcomes.

Review the appropriate recording and stimulation sites of the medial and lateral plantar nerves.

Identify common pitfalls when conducting ENG of the tibial nerve and its branches, and EMG of the intrinsic foot muscles.

Describe the diagnostic findings of tarsal tunnel syndrome found on ENG and EMG.

This activity will briefly discuss the etiology and pathophysiology of tarsal tunnel syndrome in addition to describing how ENG and EMG can be used to identify this condition.

Clinical evaluation, electroneurography (ENG), and electromyography (EMG) are used to diagnose this neuropathy of the posterior tibial nerve, thereby allowing for more accurate treatment and management plans to help alleviate the patient’s symptoms. Tarsal tunnel syndrome is a relatively rare mononeuropathy of the lower extremities that can be difficult to diagnose.