Clinical Significance of Anatomic Peculiarities and Ultrasound-Guided Electromyography of the Posterior Tibial Muscle

Fatma Elleuch; Wafa Elleuch; Harbi Houcem; Sameh Ghroubi; Habib M Elleuch

doi:10.7759/cureus.18719

Clinical Significance of Anatomic Peculiarities and Ultrasound-Guided Electromyography of the Posterior Tibial Muscle

Cureus. 2021 Oct 12;13(10):e18719. doi: 10.7759/cureus.18719. eCollection 2021 Oct.

Authors

Fatma Elleuch¹, Wafa Elleuch², Harbi Houcem³, Sameh Ghroubi⁴, Habib M Elleuch⁵

Affiliations

¹ Department of Physiology, Habib Bourguiba Hospital, University of Sfax, Sfax, TUN.
² Deaprtment of Physical Medicine and Rehabilitation, Habib Bourguiba Hospital, University of Sfax, Sfax, TUN.
³ Department of General Surgery, Habib Bourguiba Hospital, University of Sfax, Sfax, TUN.
⁴ Department of Physical Medicine and Rehabilitation, Habib Bourguiba Hospital, University of Sfax, Sfax, TUN.
⁵ Department of Physical Medicine and Rehabilitation & Research Laboratory LR20ES09, Habib Bourguiba Hospital, University of Sfax, Sfax, TUN.

Abstract

The posterior tibial muscle (PTM) is a key muscle in diagnosing the level of the neurologic lesion that causes steppage gate that is a paralysis of nervous origin of the muscles ensuring the foot dorsiflexion. The aim of this manuscript is to illustrate the anatomical peculiarities of the PTM, the ultrasound (US) anatomy of the infero-posterior part of the leg, and the technique of US-guided electro-neuro-myography (ENMG) of the PTM, which is considered a key muscle in the diagnosis of the neurological lesion causing steppage gate. The US-guided ENMG of the PTM is technically easy and safe for young practitioners provided there is a good knowledge of US anatomy of the infero-posterior part of the leg.

Keywords: electromyography; foot drop; posterior tibial muscle; steppage gate; ultrasound.