title: Nerve ultrasound in electrophysiologically verified tarsal tunnel syndrome.
abstract: Tarsal tunnel syndrome (TTS) arises from tibial nerve damage under the flexor retinaculum of the fibro-osseus tunnel at the medial malleolus. It is notoriously difficult to diagnose, as many other foot pathologies result in a similar clinical picture. We examined the additional value of nerve ultrasound in patients with tarsal tunnel syndrome confirmed by nerve conduction.
  
  
  
  We performed a retrospective analysis of nerve ultrasound changes in electrophysiologically confirmed TTS spanning our records from 2007 to 2015.
  
  
  
  Nine feet with TTS were identified, all of which showed abnormal nerve ultrasound findings, which in 6 feet, led to identification of the underlying cause.
  
  
  
  This study shows that nerve ultrasound is abnormal in all cases of electrophysiologically verified TTS. The pattern of nerve abnormality is varied. This, and the fact that in the majority of patients causation was identified, suggests nerve ultrasound should form part of standard work-up for TTS. Muscle Nerve 53: 906-912, 2016.
authors.affiliation: Neurology, National University Health Systems, Singapore.
authors.forename: Duminda
authors.initials: D
authors.lastname: Samarawickrama
authors.affiliation: Neurology, National University Health Systems, Singapore.
authors.forename: Aravinda K
authors.initials: AK
authors.lastname: Therimadasamy
authors.affiliation: Neurology, National University Health Systems, Singapore.
authors.forename: Yee Cheun
authors.initials: YC
authors.lastname: Chan
authors.affiliation: Neurology, National University Health Systems, Singapore.
authors.forename: Joy
authors.initials: J
authors.lastname: Vijayan
authors.affiliation: Neurology, Yong Loo Lin School of Medicine, National University of Singapore, 1 Kent Ridge Crescent, 119228, Singapore.
authors.forename: Einar P
authors.initials: EP
authors.lastname: Wilder-Smith
mesh_terms: D000200:Action Potentials / Q000502:physiology; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology*; D012189:Retrospective Studies; D013641:Tarsal Tunnel Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D013979:Tibial Nerve / Q000000981:diagnostic imaging / Q000503:physiopathology; D014463:Ultrasonography / Q000379:methods*
keywords: nerve conduction; nerve ultrasound; posterior tibial nerve; sonography; tarsal tunnel syndrome; tibial nerve entrapment