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Multigen RF lesion generator .
14-AUGUST-2021 BASHA'ER AMEEN AL-SAMIRAEE 63 YEARS LEFT
TARSAL TUNNEL AND RIGHT CARPAL TUNNEL SYNDROMES.
Anamnesis
The patient came to the clinic 01-August-2021
complaining of bilateral ankles and feet pain
for 8 moths, sudden onset, more the left with
pain medial aspect of the ankles and shooting to
the medial arch of the feet with burning
sensation of the soles. The patient diagnosed
with Sjogren syndrome the last 4 months, but
allergic to medications. The patient is in
hydroxychloroquine 200 mg twice daily, Crestore
20 mg once daily, Arava 20 mg once daily and
Lyrica 75 mg once daily.
On examination, the patient has normal feet
configuration with normal gait and walking.
Tinel sign positive over both posterior tibial
nerves. Severe pain over calceneal sustentaculi.
The patient sent for EMG and MRI investigations,
which done the next day confirming presence of
bilateral tarsal tunnel syndrome, more the left
and bilateral carpal tunnel syndrome more the
right. MRI of the feet were inconclusive.
Under G.A, with tourniquet to
the left foreleg, 2 separate incisions were done
over the projection of the left posterior tibial
nerve. In the above incision the posterior
tibial nerve was found and neurolysis was
achieved, releasing during that the edge of the
tarsal tunnel was bisected and the three major
divisions of the nerve were identified,
released. Right CT-release was done. She was sent to the ward.
FOLLOW UP
Too early now.
Comments
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