Ultrasound facilitates the diagnosis of tarsal tunnel syndrome: intraneural ganglion cyst of the tibial nerve

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Wu W., Chang K., ÖZÇAKAR L.

JOURNAL OF ULTRASOUND, vol.22, no.1, pp.95-98, 2019 (ESCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 22 Issue: 1
  • Publication Date: 2019
  • Doi Number: 10.1007/s40477-018-0314-5
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, EMBASE, MEDLINE
  • Page Numbers: pp.95-98
  • Keywords: Tibial nerve, Ultrasound, Ganglion, Tarsal tunnel, MAGNETIC-RESONANCE NEUROGRAPHY, PERONEAL, SONOGRAPHY
  • Hacettepe University Affiliated: Yes


The tibial nerve intraneural ganglion cyst-which presents with fluid accumulated inside the nerve epineurium-is a rare etiology of tarsal tunnel syndrome. We report a case with insidious onset of numbness over his left medial ankle. Ultrasound imaging revealed that the tibial nerve was encircled by crescent-shaped anechoic substances, spanning from the distal leg to the sole. Magnetic resonance imaging disclosed a thickened tibial nerve wrapped by hyperintense materials in the tarsal tunnel. Some effusion was observed besides the tibialis posterior and flexor digitorum tendons as well. The patient underwent a surgical treatment and an intraneural ganglion cyst was confirmed. This report elaborated the clinical and imaging presentations of a tibial nerve intraneural ganglion cyst and highlighted the usefulness of ultrasound in exploring the cause of compressive neuropathy at the ankle region.