Tarsal tunnel syndrome masked by painful diabetic polyneuropathy


ÖRMECİ T., Mahirogullari M., Aysal F.

International Journal of Surgery Case Reports, vol.15, pp.103-106, 2015 (Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 15
  • Publication Date: 2015
  • Doi Number: 10.1016/j.ijscr.2015.08.033
  • Journal Name: International Journal of Surgery Case Reports
  • Journal Indexes: Scopus
  • Page Numbers: pp.103-106
  • Keywords: Tarsal tunnel syndrome, Diabetic polyneuropathy, Pain, Magnetic resonance, Superficial ultrasound
  • Istanbul Medipol University Affiliated: Yes

Abstract

Introduction Various causes influence the etiology of tarsal tunnel syndrome including systemic diseases with progressive neuropathy, such as diabetes. Presentation of case 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. Discussion 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. Conclusion It is essential to investigate more localized reasons like tarsal tunnel syndrome that may mimic diabetic neuropathy, should be treated primarily.