Located between the FDL and FHL tendons at the posteromedial aspect of the ankle is the neurovascular bundle consisting of posterior tibial artery and vein, and tibial nerve (Fig. 32). Symptoms of pain or numbness in the distribution of the medial or lateral plantar nerves may be caused by compression of the tibial nerve or plantar nerves, and have been referred to as tarsal tunnel syndrome . There are multiple possible etiologies for tarsal tunnel syndrome, including fracture , flexor tendon tear , ganglion , accessory muscle (Fig. 33) , or osteophyte (Fig. 34). When imaged with high-resolution techniques, the tibial nerve and plantar nerves may be visualized in nearly their
Fig. 38. Axial FSE image demonstrates normal appearance to the anterior tibial tendon (large white arroW), extensor hallucis longus (black arrow), and extensor digitorum longus (small white arrow).
entire length (Fig. 35), allowing demonstration of nerve compression by an adjacent structure. Treatment depends on etiology, but when appropriate, surgery of tibial nerve lesions demonstrates good results .
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