American Journal of Roentgenology, Vol 155, 323-328, Copyright © 1990 by American Roentgen Ray Society

ARTICLES

MR imaging of the tarsal tunnel and related spaces: normal and abnormal findings with anatomic correlation

SJ Erickson, SF Quinn, JB Kneeland, JW Smith, JE Johnson, GF Carrera, MJ Shereff, JS Hyde and A Jesmanowicz
Department of Radiology, Medical College of Wisconsin, Milwaukee 53226.

The tarsal tunnel syndrome may be caused by extrinsic or intrinsic pressure on the posterior tibial nerve or its terminal branches. The specific symptoms depend on the extent of nerve involvement, and compression distal or proximal to the tarsal tunnel may result in variants of the syndrome. To define better the capability of MR imaging for evaluating this entity, we performed MR imaging on three normal subjects and correlated the images with cryomicrotome sections. Six patients with symptoms suggestive of tarsal tunnel syndrome also were studied with MR. In all normal subjects, MR images showed the flexor retinaculum and the structures passing deep to the retinaculum: the tibialis posterior tendon, flexor digitorum longus tendon, flexor hallucis longus tendon, and the posterior tibial neurovascular bundle. The medial calcaneal sensory branch(es) and the medial and lateral plantar nerves also were delineated. Mechanical causes of compression were shown in all six symptomatic patients. The pathologic entities included two neurilemomas, tenosynovitis involving all three tendons, a ganglion cyst arising from the flexor hallucis longus tendon sheath, posttraumatic fibrosis, and post-traumatic fibrosis with associated posttraumatic neuroma. The MR findings were confirmed surgically in five cases. MR imaging can accurately depict the contents of the tarsal tunnel and the courses of the terminal branches of the posterior tibial nerve. In our small series, MR imaging accurately showed the lesions responsible for tarsal tunnel syndrome.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				A. Best, E. Giza, J. Linklater, and M. Sullivan Posterior Impingement of the Ankle Caused by Anomalous Muscles. A Report of Four Cases J. Bone Joint Surg. Am., September 1, 2005; 87(9): 2075 - 2079. [Full Text] [PDF]

				J.-B. Na, A. G. Bergman, L. M. Oloff, and C. F. Beaulieu The Flexor Hallucis Longus: Tenographic Technique and Correlation of Imaging Findings with Surgery in 39 Ankles Radiology, September 1, 2005; 236(3): 974 - 982. [Abstract] [Full Text] [PDF]

				M. Nagaoka and H. Matsuzaki Ultrasonography in Tarsal Tunnel Syndrome J. Ultrasound Med., August 1, 2005; 24(8): 1035 - 1040. [Abstract] [Full Text] [PDF]

				S. Masala, R. Fiori, A. Marinetti, L. Uccioli, L. Giurato, and G. Simonetti Imaging the Ankle and Foot and Using Magnetic Resonance Imaging International Journal of Lower Extremity Wounds, December 1, 2003; 2(4): 217 - 232. [Abstract] [PDF]

				Z. S. Rosenberg, J. Beltran, and J. T. Bencardino MR Imaging of the Ankle and Foot RadioGraphics, October 1, 2000; 20(90001): 153S - 179. [Abstract] [Full Text]

				J. A. Narvaez, J. Narvaez, R. Ortega, C. Aguilera, A. Sanchez, and E. Andia Painful Heel: MR Imaging Findings RadioGraphics, March 1, 2000; 20(2): 333 - 352. [Abstract] [Full Text] [PDF]