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Old 07-09-2009, 08:32 PM   #1
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Tarsal Tunnel MRI diagnose?

Can an MRI diagnose Tarsal Tunnel Syndrome? My doctor said that I have TTS and is ordering an MRI for me. I broke my left foot about 5 years ago. I walked off a curb not knowing there was a curb and my foot turned and it broke. I wore a cast and then it seems like I've struggled with my foot ever since. X-rays showed that it healed totally, but I have pretty severe pain on the right side and I developed scar tissue in my heel.

I had surgery to get rid of the scar tissue but that just made things worse. The doctor cut across my heel and I developed a lot of scarring around that and lots of pain in my heel area, some of it electrical. I went to a new doctor and he said that I have a cuboid bone is that is getting out of joint and some ligament damage. (I think it must be from my first fracture as this is the area that has hurt since I broke my foot, but I guess we will never know for sure.) The doctor said I'm compensating for the pain on both sides and it's making things worse.

He said I need TTS surgery and that that should fix my problems with the cuboid socket as well. I really love my doctor, but am not wanting to have another surgery if it won't help.

He has ordered an MRI - what can that tell? I read where someone was talking about contrast dye in an MRI - can that tell me more?

 
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Old 07-09-2009, 10:08 PM   #2
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Re: Tarsal Tunnel MRI diagnose?

Hi,

I have Anterior Tarsal Tunnel following three foot surgeries and am facing the same decision. The difference is that it is my deep peroneal nerve that is entrapped so my pain is more at the front of the ankle, going across the top towards the big toe. My first diagnosis came by way of a nerve conduction study/EMG. My ortho sent me to the neurologist after I developed some foot drop and weakness. The test showed that I basically had no conduction past the ankle joint. I went for a round of PT and the foot drop did resolve. However, I still have the pain and numbness.

That was a year ago. I have managed the pain with injections to block the nerve. So far I've had two. My doctor really doesn't want to do surgery (nor do I) as he isn't happy with the success rate of nerve release and my foot has already had a lot of trauma. Also, there is no guarantee the nerve is not damaged. We wouldn't know that until after the surgery (and I didn't get better). That being said, there are those who have had successful nerve release surgeries. However, many have to have them repeated.

As far as the MRI, my neuro told me it is difficult to show up in an MRI but you sometimes see things that indicate it. I had an MRI about a month ago to evaluate things and it showed atrophy of the EDB muscle which is the one supplied by the deep peroneal nerve. So, in effect, the MRI confirmed the Tarsal Tunnel.

The decision whether to have surgery or not is indeed a difficult one when you have had multiple surgeries as we have. Every time they go in there the foot suffers more trauma. However, the prospect of living with pain the rest of my life is daunting. But surgery is no guarantee either. I am now with a pain management doctor. My pain is manageable and fortunately, I am on fairly mild pain relievers which give me very few side effects and I am able to do most anything I want to within reason. I can't walk long distances without pain and I can't be on my feet for long without having to take a break, but I've learned to adapt. For now, I've chosen to take a wait and see approach. If the pain gets much worse or I develop too much weakness then I may have no choice.

You can always get another opinion, but I would have the MRI done anyway so you can see exactly what's going on. Tarsal tunnel may not show up, but it would rule out other problems. It is a tough decision. I would recommend taking your time, researching, possibly getting another opinion, then decide what is best for you. Only you can ultimately decide but I would be happy to answer any questions you may have or someone else on here may offer some additional insight.

Best of luck to you. Let us know how you are doing.

emmie

 
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Old 07-09-2009, 11:32 PM   #3
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Re: Tarsal Tunnel MRI diagnose?

Thanks Emmie54 for the input. My surgeon removed a nerve in the last surgery and he said he thought he may need to remove another nerve. He said something about going in and maybe having to go above my ankle to make sure he got rid of all the bad nerve. (If that makes no sense, it's my fault not my doctors as it's all pretty technical to me.) We did an EMG and it did not show anything, but my doctor said that he is pretty sure based on all the symptoms that I do have it. I am like you in that I can't walk for any length of time without my foot really hurting. At night is when it seems to be the worst.

I would wait a bit except for a couple of things. One, my doctor told me that if I don't get it fixed that I will be causing more problems with the cuboid socket and that more nerves will be involved. Also, I don't know how much longer I will have insurance. Right now I've met my deductible and co payments, so it wouldn't cost me anything. But I'm not sure if next year I can afford the insurance.

I do have a lot of trust in my doctor. I don't think I would be walking after my botched first surgery if I hadn't found him. I went to a very impressive Orthopedic foot surgeon in Houston and he made a real mess of my feet. I still have problems with an over corrected bunion as well as shortening of my big toes that is now causing pain in my adjoining toes. I also have instability in my feet because of the first surgery and the scar that is now causing such havoc. I couldn't even walk after the first surgery and the Orthopedic doctor just tried to blow me off. I found my current doctor and he knew immediately what was wrong and I had another surgery which helped considerably. He really is pretty conservative knowing my feet and has talked me out of correcting my bunion right now.

But neither surgery was easy and this seems like it will be more difficult to recover from, so I'm really wanting to make sure before we go ahead.

 
Old 07-10-2009, 09:32 AM   #4
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Re: Tarsal Tunnel MRI diagnose?

It sounds like you have a good guy this time and he is running all the necessary tests. Your situation is different than mine and in your case, maybe I would go ahead with it since there is a danger of further damage. It's so important to trust your doctor. I'm glad you found this one.

I hear what you are saying about night pain. It is the worst. If I could just have daytime 24/7 I would have very little pain!

good luck with whatever you decide. I'll be following your case with interest.

emmie

 
Old 09-01-2009, 09:12 PM   #5
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Re: Tarsal Tunnel MRI diagnose?

HELP!! We have a 13 year old boy who is back in a wheelchair. He has been treated twice at Arkansas Children's Hospital and seen many, many other doctors. He has severe ankle pain and all indications are that it's tarsal tunnel syndrome. However, we were not pleased with the level of care at ACH and would like to find someone who specializes in TTS. We live in Texarkana, Texas and I'm willing to take him just about anywhere at this point. Luckily, we have great insurance and the deductible has been met. Drew has had over 25k in medical bills this year with very little improvement. Right now, the doctors have him on Lyrica three times a day and they want to up the dosage. HELP!!!

 
Old 09-01-2009, 09:42 PM   #6
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Re: Tarsal Tunnel MRI diagnose?

TexasReverie - I found a doctor in Houston who specializes in nerves in the foot. I went to him recently and really like him. You might check him out. His name is Dr. Robert Parker.

I talked with my regular podiatrist and he told me that he has high respect for Dr. Parker.

Good luck with your son!

Last edited by moderator2; 09-02-2009 at 09:18 AM. Reason: posted disallowed website(s) - please read the posting rules

 
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