Best Practice Case Studies-Ankle

Pdf Summary

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