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Ankle - Case 4 (3rd ed)
Ankle - Case 4 (3rd ed)
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The document addresses differential diagnoses for plantar heel pain and tests one's knowledge on the characteristics of tarsal tunnel syndrome and posterior tibialis tendon injury.<br /><br />For the first question, it clarifies that tarsal tunnel syndrome is an entrapment neuropathy of the posterior tibial nerve located in the tarsal tunnel. This syndrome is characterized by pain in the medial ankle and heel that increases with walking and gradually improves with rest (Answer C). Unlike plantar fasciitis, which is famous for causing “first-step” pain when rising from rest, tarsal tunnel syndrome's pain is associated with activity and subsides with rest. The condition can be easily confused with plantar fasciitis, but both conditions can occur simultaneously.<br /><br />For the second question, the correct answer highlights that pain with passive pronation and active supination suggests a posterior tibialis tendon injury (Answer D). This distinguishes it from other conditions: burning, tingling, or numbness in the plantar aspect of the foot indicates tarsal tunnel syndrome; pain on toe-off or forefoot weight-bearing points to flexor hallucis longus tendinosis; and pain with resisted dorsiflexion and passive inversion is indicative of extensor digitorum or anterior tibialis tendinopathy.<br /><br />These insights from the study questions help differentiate between complex conditions affecting the foot and ankle, emphasizing the importance of targeted diagnosis through characteristic symptoms and activity-induced pain. This differentiation is crucial for proper treatment and management in clinical practice.
Meta Tag
Edition
3rd Edition
Related Case
3rd Edition, CASE 04
Topic
Ankle
Keywords
plantar heel pain
differential diagnosis
tarsal tunnel syndrome
posterior tibialis tendon injury
entrapment neuropathy
medial ankle pain
plantar fasciitis
passive pronation
active supination
foot and ankle conditions
3rd Edition
3rd Edition, CASE 04
Ankle
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