Accessory Flexor Digitorum Longus Presenting as Tarsal Tunnel Syndrome: A Case Series.
Drew B ParkhurstMathew R SaffarianMichael T AndaryRyan S FajardoJeffrey J KnakePublished in: Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine (2022)
Tarsal tunnel syndrome (TTS) typically occurs from extrinsic or intrinsic sources of compression on the tibial nerve. We present 3 cases of patients, all of whom have a prolonged time to diagnosis after evaluation with multiple specialties, with foot pain ultimately secondary to an accessory flexor digitorum longus muscle causing TTS. The literature describing the association between TTS and accessory musculature has been limited to single case reports and frequently demonstrate abnormal electrodiagnostic testing. In our series, 2 cases had normal electrodiagnostic findings despite magnetic resonance imaging (MRI) that later revealed TTS and improvement with eventual resection. A normal electromyogram should not preclude the diagnosis of TTS and MRI of the ankle; it should be considered a useful diagnostic tool when examining atypical foot pain.
Keyphrases
- magnetic resonance imaging
- contrast enhanced
- chronic pain
- case report
- end stage renal disease
- pain management
- neuropathic pain
- ejection fraction
- diffusion weighted imaging
- newly diagnosed
- chronic kidney disease
- computed tomography
- systematic review
- peritoneal dialysis
- skeletal muscle
- prognostic factors
- drinking water
- single cell
- spinal cord injury
- spinal cord