Can the axial cross-sectional area of the tibial nerve be used to diagnose tarsal tunnel syndrome? An ultrasonography study

Fantino, O.; Bouysset, M.; Pialat, Jean‐Baptiste

doi:10.1016/j.otsr.2020.02.021

Cited by 14 publications

(11 citation statements)

References 21 publications

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“…Nerve conduction velocity is one of the parameters widely used to assess pathologies such as TN entrapment neuropathy or diabetic neuropathy [ 5 , 6 ] ; however, this method is painful and difficult for comprehensive assessment within a short timeframe. The cross-sectional area of the TN [ 7 ] is helpful for TN assessment; however, individual differences in body height, body weight, and foot length may influence the outcome. Therefore, better noninvasive quantitative methods for the assessment of TN neuropathy are needed.…”

Section: Introductionmentioning

confidence: 99%

Changes in tibial nerve stiffness during ankle dorsiflexion according to in-vivo analysis with shear wave elastography

et al. 2022

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A more detailed assessment of pathological changes in the tibial nerve (TN) is needed to better assess how physical therapy influences TN pathologies. The cross-sectional nerve area can be used for TN assessment but may be influenced by individual differences in parameters, such as body height, body weight, and foot length. Therefore, there are no known reliable noninvasive quantitative methods for assessing TN neuropathy. Although recent ultrasonographic studies reported that TN stiffness changes could be used to assess TN neuropathies of the foot, these studies did not consider the joint position, and peripheral nerve tension can change with joint movement. Therefore, we considered that TN stiffness assessment could be improved by analyzing the relationship between ankle joint position and TN stiffness. This study aimed to investigate the relationship between TN stiffness and ankle angle changes using shear wave elastography. We hypothesized that the TN shear wave velocity significantly increases with ankle dorsiflexion and that the total ankle range or maximum dorsiflexion range correlates with the shear wave velocity. This cross-sectional study included 20 TNs of 20 healthy adults. Ultrasonography and shear wave elastography were used to evaluate the TN. TN stiffness was measured at 5 ankle positions as follows: maximum dorsiflexion (100% df), plantar flexion in the resting position (0% df), and 3 intermediate points (25% df, 50% df, and 75% df). TN shear wave velocity increased with an increase in ankle df angle. While total ankle range was significantly and negatively correlated with TN stiffness in all ankle positions, the maximum ankle df angle was significantly and negatively correlated only at 75% and 100% df. TN stiffness below 50% df may be affected by gliding or decreased nerve loosening, and TN stiffness above 75% df may be influenced by nerve tensioning. When measuring TN stiffness for diagnostic purposes, TN should be assessed at an ankle joint angle below 50% df.

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Section: Introductionmentioning

confidence: 99%

Changes in tibial nerve stiffness during ankle dorsiflexion according to in-vivo analysis with shear wave elastography

et al. 2022

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“…Fantino i suradnici usporedili su 27 sto- pala s kliničkim i prisutnim EMNG znakovima STT-a sa 21 zdravom osobom te kao graničnu referentnu vrijednost za ttCSA predložili 15 mm 2 sa 75 % osjetljivosti i 100 % specifičnosti. U ovoj studiji najbolja granična referentna vrijednost za ΔCSA bila je 5 mm 2 sa 81 % osjetljivosti i 100 % specifičnosti 18 . Boyd i Dilley uspoređivali su CSA prilikom kretnji u gležnju na pacijentima s dijabetesom melitusom (DM) i na zdravoj populaciji te su ustanovili da je u osoba s dijabetesom melitusom CSA tibijalnog živca značajno veći 19 .…”

Section: Ultrazvučna Evaluacijaunclassified

Sindrom tarzalnog tunela

Kavanagh

Balen

Nemčić

2022

Med. Flum. (Online)

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Sindrom tarzalnog tunela (STT) relativno je rijetka kompresivna mononeuropatija donjih ekstremiteta uzrokovana kompresijom tibijalnog živca ili njegovih ogranaka (medijalnog ili lateralnog plantarnog živca) u području tarzalnog kanala. Pripada skupini kanalikularnih sindroma, a iako puno rjeđi, može se smatrati ekvivalentnim sindromu karpalnog tunela. Klinički se očituje pojavom boli, poglavito u medijalnom dijelu tabana te žarenjem i trncima u području prva tri prsta stopala. Uz kliničku procjenu, za dijagnosticiranje ove neuropatije najčešće se koriste elektrodijagnostičke pretrage – elektroneurografija (ENG) i elektromiografija (EMG), te ultrazvučna pretraga. Liječenje STT-a može biti konzervativno i kirurško. Konzervativno liječenje preporučuje se bolesnicima s lakšim do umjerenim tegobama, dok se kirurško liječenje provodi u bolesnika s težim oštećenjima. Cilj je ovog preglednog rada prikazati novije spoznaje vezane za STT s naglaskom na potvrdu kliničke dijagnoze najčešće korištenim dijagnostičkim pretragama kao što su elektroneurografija (ENG) i elektromiografija (EMG) te ultrazvučni pregled.

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“…The yield is generally higher (67%–100%) than other focal mononeuropathies (Table 4), as TTS is usually secondary to a specific structural cause 83 . Many of these findings are confirmed surgically or on magnetic resonance imaging, and many are not detectable on physical examination 84–86 . Surgery for TTS is usually successful when a space-occupying lesion is found 83 .…”

Section: Specific Conditionsmentioning

confidence: 99%

Neuromuscular Ultrasound

Jorgensen

Cartwright

Norbury

2021

Am J Phys Med Rehabil

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Accurate assessment of neuromuscular disorders is critical to facilitate timely treatment and achieve the best outcomes. Historically, electrodiagnostic studies have filled this role, but recently, neuromuscular ultrasound is being used in the electrodiagnostic laboratory. This review discusses the uses of neuromuscular ultrasound in the electrodiagnostic laboratory that have strong evidence, emphasizing those that could be adopted in a typical electrodiagnostic laboratory with a reasonable level of equipment and training. The evidence currently supports using neuromuscular ultrasound to diagnose carpal tunnel syndrome and ulnar neuropathies at the elbow and as a supplementary test when electrodiagnostic studies are suspected to be falsely negative or in axonal nonlocalizing lesions. Neuromuscular ultrasound can identify the causes of focal mononeuropathies, which can change treatment in specific cases. It is sensitive at identifying fasciculations and providing complementary evidence of autoimmune demyelinating polyneuropathies. It is particularly helpful in assessing nerves after trauma. Neuromuscular ultrasound is likely to prove even more useful in the electrodiagnostic laboratory as the technology continues to advance.

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Can the axial cross-sectional area of the tibial nerve be used to diagnose tarsal tunnel syndrome? An ultrasonography study

Cited by 14 publications

References 21 publications

Changes in tibial nerve stiffness during ankle dorsiflexion according to in-vivo analysis with shear wave elastography

Changes in tibial nerve stiffness during ankle dorsiflexion according to in-vivo analysis with shear wave elastography

Sindrom tarzalnog tunela

Neuromuscular Ultrasound

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