Usefulness of electrodiagnostic techniques in the evaluation of suspected tarsal tunnel syndrome: an evidence-based review.
This evidence-based review was performed to evaluate the utility of nerve conduction studies (NCSs) and needle electromyography (EMG) in the diagnosis of tibial neuropathy at the ankle (tarsal tunnel syndrome, TTS). A total of 317 articles on TTS were identified that were published in English from 1965 through April 2002, from the National Library of Medicine MEDLINE database. All articles were reviewed on the basis of six selection criteria. The results of this search revealed that four articles met five or more criteria. All four articles examined the use of electrodiagnostic (EDX) techniques for the evaluation of patients with clinically suspected TTS, and were included in this practice parameter. Each of these four studies was considered to meet Class III level of evidence. NCSs were abnormal in some patients with suspected TTS. Sensory NCSs were more likely to be abnormal than motor NCSs but the actual sensitivity and specificity could not be determined. The sensitivity of needle EMG abnormalities could not be determined. NCSs may be useful for confirming the diagnosis of tibial neuropathy at the ankle, recommendation Level C. Well-designed studies are needed to evaluate more definitively EDX techniques in TTS.
Patel
Atul T
AT
American Association of Neuromuscular & Electrodiagnostic Medicine, 421 First Avenue SW, Suite 300E, Rochester, Minnesota 55902, USA.
Gaines
Kenneth
K
Malamut
Richard
R
Park
Tracy A
TA
Toro
David R Del
DR
Holland
Neil
N
D000200:Action Potentials / Q000502:physiology; D000842:Ankle / Q000503:physiopathology*; D002986:Clinical Trials as Topic / Q000592:standards; D016206:Databases, Bibliographic; D004568:Electrodiagnosis / Q000379:methods / Q000592:standards*; D004576:Electromyography / Q000379:methods / Q000592:standards; D019317:Evidence-Based Medicine; D006801:Humans; D009431:Neural Conduction / Q000502:physiology; D010291:Paresis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D012678:Sensation Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D013641:Tarsal Tunnel Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D013979:Tibial Nerve / Q000503:physiopathology*