A Ganglion Cyst around the Tarsal Tunnel Detected by Ultrasonography and MRI -A case report-

Abstract

Tarsal tunnel syndrome is often misdiagnosed it shares clinical features with other diseases of the lower extremity such as lumbar radiculopathy and arthritis. Failure to diagnose and treat neuropathies effectively can cause permanent neuropathic pain. We report a case of a ganglion cyst detected early using ultrasonography and MRI in a 51-year-old man who complained of rapidly aggravating pain, numbness and paresthesia on the great toe and the first metatarsal area in the sole, symptoms that resembled tarsal tunnel syndrome. Surgical treatment could be performed early with no permanent sequelae. We could also avoid repeated steroid injections or prescription medications. ( In most cases, TTS develops from unknown causes and can be treated conservatively. However, early surgical intervention is mandatory when neuropathy arises from a progressing occult pathology to avoid, repeated steroid injections, prescription of several medication for neuropathic pain, and to prevent permanent neuropathic pain.MRI and electromyography, together with clinical history and physical examination, can help to make the differential diagnosis. Ultrasonography (USG) can also be a useful technique for differential diagnosis of TTS, especially for detecting occult masses because of its non-invasiveness and real time views.Here, we introduce a case of a ganglion cyst around the tarsal tunnel that was diagnosed using USG at the first visit and treated surgically before lasting neurologic changes occured.