Ultrasound-Guided Near-Nerve Needle Sensory Technique for the Diagnosis of Tarsal Tunnel Syndrome

Lorena Vega-Zelaya; Álvaro Iborra; Manuel Villanueva; Jesús Pastor; Concepción Noriega

doi:10.3390/jcm10143065

Ultrasound-Guided Near-Nerve Needle Sensory Technique for the Diagnosis of Tarsal Tunnel Syndrome

J Clin Med. 2021 Jul 11;10(14):3065. doi: 10.3390/jcm10143065.

Authors

Lorena Vega-Zelaya^{1

2}, Álvaro Iborra^{1

3}, Manuel Villanueva^{1

3}, Jesús Pastor², Concepción Noriega⁴

Affiliations

¹ Avanfi Institute, Calle Donoso Cortes 80, 28015 Madrid, Spain.
² Clinical Neurophysiology, Hospital Universitario de La Princesa, C/Diego de León 62, 28006 Madrid, Spain.
³ Unit for Ultrasound-Guided Surgery, Hospital Beata María Ana, 28007 Madrid, Spain.
⁴ Department of Nursery and Physiotherapy, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain.

Abstract

Background: Tarsal tunnel syndrome (TTS) is one of the most common entrapment syndromes. Although diagnosis is supported by imaging tests, it has so far been based on clinical findings. Neurophysiological tests are not effective for providing an accurate diagnosis. The objective of this study was to analyze the efficacy of the ultrasound-guided near-nerve needle sensory technique (USG-NNNS) for the diagnosis of TTS Methods: The study population comprised 40 patients referred for a neurophysiological study owing to clinical suspicion of TTS. Routine neurophysiological tests were performed and compared with the results of USG-NNNS.

Results: The diagnosis of TTS was achieved in 90% of cases. We found significant differences between lateral plantar sensory recordings with surface electrodes and USG-NNNS techniques for amplitude, nerve conduction velocity (NCV), and duration. As for the medial plantar sensory recordings, differences were found only for duration. No responses were obtained with surface electrode studies in 64.8% of cases. In addition, we observed normal sensory NCV with surface electrodes in 20 patients, although this decreased when the NNNS technique was used.

Conclusions: This is the first report of the efficacy of the USG-NNNS technique for confirming the diagnosis of TTS.

Keywords: electrodiagnosis; near-nerve needle sensory technique; nerve conduction studies; nerve entrapments; neurophysiology; tarsal tunnel syndrome; tibial nerve; ultrasound-guided.