Tarsal tunnel syndrome masked by painful diabetic polyneuropathy.
BACKGROUND
Various causes influence the etiology of tarsal tunnel syndrome including systemic diseases with progressive neuropathy, such as diabetes.


METHODS
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.


CONCLUSIONS
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.


CONCLUSIONS
It is essential to investigate more localized reasons like tarsal tunnel syndrome that may mimic diabetic neuropathy, should be treated primarily.
Medipol University, Faculty of Medicine, Department of Radiology, İstanbul, Turkey. Electronic address: tug_ormeci@yahoo.co.uk.
Tugrul
T
Ormeci
Medipol University, Faculty of Medicine, Department of Orthopedics and Traumatology, İstanbul, Turkey. Electronic address: mmahirogullari@medipol.edu.tr.
Mahir
M
Mahirogulları
Medipol University, Faculty of Medicine, Department of Neurology, İstanbul, Turkey. Electronic address: fikretaysal@yahoo.com.
Fikret
F
Aysal
Diabetic polyneuropathy; Magnetic resonance; Pain; Superficial ultrasound; Tarsal tunnel syndrome