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Foot & Ankle
intermediate
X-Type

Tarsal Tunnel Syndrome - Diagnosis and Surgical Decompression

Nerve Entrapment

A 48-year-old woman presents with burning pain in the sole of her foot and toes that worsens at night and with prolonged standing. Examination reveals a positive Tinel sign posterior to the medial malleolus and reproduces her symptoms with the dorsiflexion-eversion stress test. MRI shows a ganglion cyst in the tarsal tunnel. She has failed 4 months of conservative treatment including orthotics and corticosteroid injection. Regarding tarsal tunnel syndrome:

Mark each as TRUE or FALSE

A

The tarsal tunnel contains structures in order from anterior to posterior: tibialis posterior, flexo...

B

The posterior tibial nerve has three terminal branches: medial calcaneal nerve (branches first, sens...

C

Space-occupying lesions are rarely identified as a cause; the dorsiflexion-eversion test has the low...

D

The Tinel sign (tapping posterior to medial malleolus) has high specificity (92%); the dorsiflexion-...

E

Surgical decompression must include release of the flexor retinaculum AND extension through the abdu...

Answer the questions to see explanations

Click T (True) or F (False) for each option