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Tuesday, January 1, 2013

Tarsal Tunnel Syndrome: MRI Images of Ankle Swelling

When patients experience foot and ankle nerve pain, a possible diagnosis of tarsal tunnel syndrome is suspected. Below are some MRI images noting swelling internally that could produce enough pressure on the posterior tibial nerve (marked with an arrow). In this case, an anti-inflammatory approach to reduce the swelling may significantly reduce the pressure on the nerve, easing the symptoms of nerve pain. However, in the long run, finding the cause of this inflammation will be important. The inflammatory reaction not only involves the ankle joint, but also the 3 tendons in the area (PT, FHL, and FDL) and may be a sign of an inflammatory disorder. Nerve pain, when constant and severe enough, can produce swelling, and the swelling lead to more pressure on the nerve, thus even more nerve pain. In this case, Nerve Pain Begets Nerve Pain and has a life of its own. Finding the source of the original nerve pain will be crucial to helping in the long term. 


The marked Posterior Tibial Nerve is a branch of the Sciatic Nerve as it comes off your back, through the sciatic notch, behind the hamstrings and knee, down the back of the leg, and into the medial side of the ankle (Tarsal Tunnel area) below the inside ankle bone (medial malleolus). 

Arrow marking the posterior tibial nerve quite exposed to external pressures and  being  pressured by internal swelling.

Swelling within the Tarsal Tunnel with the arrow pointing approximately where the nerve would lie.

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.