Tarsal Tunnel Syndrome Due to Varicose Vascular Structures: A Case Report

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Authors

  • Yuko Kobashi Department of Radiology, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa, Chiba 272-8513, Japan
  • Shou Ogiwara Department of Radiology, Tokyo Jikei University School of Medicine, Nishi-Shimbashi, Mina- to-ku, Tokyo 105-8461, Japan
  • Kunihiko Fukuda Department of Radiology, Tokyo Jikei University School of Medicine, Nishi-Shimbashi, Mina- to-ku, Tokyo 105-8461, Japan
  • Makoto Kubota Department of Orthopedics, Tokyo Jikei University School of Medicine, Katsushika Medical Center, 6-41-2, Aoto, Katsushikaku, Tokyo, 125-8506, Japan

DOI:

https://doi.org/10.17140/ROJ-1-103

Keywords:

Tarsal tunnel, Varicose vascular structure, MRI

Abstract

Objective: We report a case of a tarsal tunnel syndrome caused by a varicose vascular structures identified by foot MRI.
Case report: An eighty-year old male came to our attention for a chronic intermittent bilateral plantar numbness. Symptoms were evident especially in the left foot when taking a bath or after a long distance walk. Feet were bilaterally flat. Ankles range of motion was bilaterally complete and pain free. Resisted range of motion testing including resisted ankle dorsiflexion, plantar flexion, inversion, and eversion was found to be pain free and of equal strength bilaterally. Neurological testing of the lower extremities was found to be positive for the Tinel sign at level of medial malleolus. Left ankle MRI showed evidence of several varicose vascular structures. One of the varicose vascular structures was suddenly narrow at level of tarsal tunnel. Posterior tibial vein at the tarsal tunnel level was dilated and appeared to continue in the varicose vascular structure on contrast study. Diagnosis of tarsal tunnel syndrome was made both by symptoms and imaging, considering the dilatation of the posterior tibial vein and the compression of the varicose structures around the tarsal tunnel. Treatment: Resection surgery of the retinaculum was performed in order to decrease the pressure on the tarsal tunnel. The patient’s symptom reduced after the surgery. However, a few months later he referred recurrence of plantar numbness.
Conclusion: Patients who suffer from tarsal tunnel syndrome caused by a varicose vascular structures can show different symptoms if compared with those present in the same syndrome caused by other diseases. If varicose veins are detected in the tarsal tunnel and symptoms of compression are present, along with a concomitant foot deformity that predisposes to disease, diagnosis of tarsal tunnel syndrome should be considered. In order to achieve good results, the treatment of the varicose vascular structures and the correction of foot deformities are recommended together with a tarsal tunnel decompression.

References

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Published

2016-03-14

How to Cite

Yuko Kobashi, Shou Ogiwara, Kunihiko Fukuda, & Makoto Kubota. (2016). Tarsal Tunnel Syndrome Due to Varicose Vascular Structures: A Case Report. Radiology, 1(1), 17–20. https://doi.org/10.17140/ROJ-1-103

Issue

Vol. 1 No. 1 (2016): Volume 1 Issue 1 2016

Section

Articles

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