J Korean Soc Radiol.  2012 Feb;66(2):183-192. 10.3348/jksr.2012.66.2.183.

The Usefulness of the Preoperative Magnetic Resonance Imaging Findings in the Evaluation of Tarsal Tunnel Syndrome

• Jung HJ
• Lee SW
• Jeong YM
• Choi HY
• Kim HS
• Park HG
• Kwak JH

• KMID: 1439412
• DOI: http://doi.org/10.3348/jksr.2012.66.2.183

Abstract

PURPOSE
The purpose of this study was to access the diverse conditions that lead to the clinical manifestations of tarsal tunnel syndrome and evaluate the usefulness of magnetic resonance imaging (MRI) in preoperative evaluation.
MATERIALS AND METHODS
Thirty-three patients who underwent ankle MRI and surgery under the impression of tarsal tunnel syndrome were retrospectively analyzed. The findings on ankle MRI were categorized into space occupying lesions within the tarsal tunnel, space occupying lesions of the tunnel wall, and non-space occupying lesions. Associated plantar muscle atrophy was also evaluated. Medical records were reviewed for correlation of nerve conduction velocity (NCV) and surgical findings.
RESULTS
There were 21 space occupying lesions of the tarsal tunnel, and eight lesions of tarsal tunnel wall. There were three cases with accessory muscle, three with tarsal coalition, five with ganglion cysts, one neurogenic tumor, five flexor retinaculum hypertrophy, three varicose veins, and nine with tenosynovitis of the posterior tibialis, flexor digitorum longus, or flexor hallucis longus tendon. One patient was found to have a deltoid ligament sprain. Of the 32, eight patients experienced fatty atrophic change within any one of the foot muscles. NCV was positive in 79% of the MRI-positive lesions.
CONCLUSION
MRI provides detailed information on ankle anatomy, which includes that of tarsal tunnel and beyond. Pathologic conditions that cause or mimic tarsal tunnel syndrome are well demonstrated. MRI can enhance surgical planning by indicating the extent of decompression required, and help with further patient management. Patients with tarsal tunnel syndrome can greatly benefit from preoperative MRI. However, it should be noted that not all cases with tarsal tunnel syndrome have MRI-demonstrable causes.

MeSH Terms

Animals
Ankle
Decompression
Foot
Ganglion Cysts
Humans
Hydrazines
Hypertrophy
Ligaments
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Magnetics
Magnets
Medical Records
Muscles
Muscular Atrophy
Nerve Compression Syndromes
Neural Conduction
Retrospective Studies
Sprains and Strains
Tarsal Tunnel Syndrome
Tendons
Tenosynovitis
Varicose Veins
Hydrazines

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