Tarsal Tunnel Syndrome Due to Varicose Vascular Structures: A Case Report.
Various conditions have been suggested to play a role in the etiology and pathogenesis of a posteromedial tarsal tunnel syndrome. This syndrome can be idiopathic or associated with space occupying lesions including tumors, ganglion cysts from the subtalar joint or tendon sheaths, abnormal or accessory muscle (hypertrophic adductor hallucisor accessory flexor digitorum longus muscle, lipomas, varicose veins, trauma with bone spicule from an adjacent fracture, foreign bodies, iatrogenic causes such as calcaneal osteotomies with involuntary deep penetration medially, with fixation hardware or scar tissue).
Tarsal tunnel syndrome may also develop in relation to some foot deformities such as valgus/varus deformity, pes
planus and tarsal coalition. Systemic diseases such as diabetes, rheumatoid arthritis and peripheral arterial disease can play a role in this syndrome.
The main symptoms of tarsal tunnel syndrome are represented by poorly localized paresthesia, dysesthesia and
hypoesthesia in the medial and lateral plantar area. Symptoms are typically unilateral and rarely bilateral.
Tarsal tunnel syndrome caused by varicosity may show characteristic symptoms: Kumai et al reported that patients suddenly feel foot pain whenever they soak a foot in hot water.
This specific symptom occurs due to dilatation of the varicose vascular structures in the tarsal tunnel. Our patient had the same symptom thus supporting the hypothesis that the tarsal tunnel syndrome was caused by the varicose vascular structures compression.
Radiol Open J. 2016; 1(1): 17-20. doi: 10.17140/ROJ-1-103
