Tarsal tunnel syndrome caused by synovial sarcoma

Sonographic evaluation of plantar hindfoot and midfoot pain

Plantar hindfoot and midfoot pain is a common orthopedic condition. Plantar fasciopathy is the most common cause of plantar foot pain, and sonographic evaluation can easily show the characteristic pathologic changes. In addition, sonography is well suited to evaluate other potential causes of plantar foot pain. We present a review of the sonographic findings of plantar fasciopathy and other potential causes of plantar hindfoot and midfoot pain.

Calcaneal osteomyelitis presenting with acute tarsal tunnel syndrome: a case report

INTRODUCTION

Cases of acute tarsal tunnel syndrome are rare. To the best of our knowledge, we describe the only reported case of acute posterior tibial nerve compression resulting from adjacent haemotogenous pyogenic calcaneal osteomyelitis.

CASE PRESENTATION

A previously healthy 38-year-old Caucasian woman developed symptoms of acute tarsal tunnel syndrome in her right foot over a six-day period. No antecedent trauma or systemic symptoms were noted. Magnetic resonance imaging and bone scan imaging, followed by surgical decompression and bone biopsy confirmed a diagnosis of Staphylococcus aureus calcaneal osteomyelitis. Her pain and paraesthesia disappeared after the operation, while her inflammatory markers normalised during a 12-week course of antibiotics. After four years she has remained asymptomatic without any indication of recurrence.

CONCLUSION

This case is not just unique in describing osteomyelitis as a cause of tarsal tunnel syndrome, because haemotogenous calcaneal osteomyelitis is in itself a rare pathology. We recommend considering infection as a differential diagnosis in patients presenting with acute tarsal tunnel syndrome.

Delayed diagnosis of synovial sarcoma of the foot

Soft tissue sarcomas are relatively rare in the population, rarely encountered by the average orthopedic surgeon, and may only be seen once in a lifetime by a general practitioner. Although rare, it is a serious condition that, if diagnosed early, can result in improved prognosis. This article presents a case of a delayed diagnosis of a soft tissue sarcoma and highlights possible pitfalls and causes for such delays in hope of educating and reducing such incidences in the future.

Impact of psychiatric disorders on Parkinson's disease : a nationwide follow-up study from Sweden

OBJECTIVES

To analyze whether hospitalization for a psychiatric disorder predicts Parkinson's disease (PD) in men and women in different age groups after accounting for socioeconomic status and geographical region.

METHODS

Data from the MigMed database were used to identify all people in Sweden hospitalized for psychiatric disorder and PD during the study period (1987 to 2001). Standardized incidence ratios (SIRs) with 95% confidence intervals (CI) for PD were calculated among those with and without hospitalization for psychiatric disorder.

RESULTS

There were 1876 cases of PD among those with psychiatric disorder during the study period. The risk of developing PD was strongest among those under age 50; the SIR was 11.56 (95% CI 9.15-14.41). The risk was attenuated with increasing age in both men and women. There were similar risk patterns in all subtypes of psychiatric disorders in PD patients. The overall risk of PD among people with psychiatric disorders was higher for women than men.

CONCLUSIONS

A psychiatric disorder is an appreciable risk factor for the development of PD, particularly in people under age 50. The association between PD and psychiatric disorders should be taken into account by clinicians and health care providers.

Major and minor depression in Parkinson's disease: a neuropsychological investigation

Previous studies have failed to distinguish the differential contribution of major and minor depression to cognitive impairment in patients with idiopathic Parkinson's disease (PD). This study was aimed at investigating the relationships among major depression (MD), minor depression (MiD) and neuropsychological deficits in PD. Eighty-three patients suffering from PD participated in the study. MD and MiD were diagnosed by means of a structured interview (SCID-I) based on the DSM-IV criteria, and severity of depression was evaluated by the Beck Depression Inventory. For the neuropsychological assessment, we used standardized scales that measure verbal and visual episodic memory, working memory, executive functions, abstract reasoning and visual-spatial and language abilities. MD patients performed worse than PD patients without depression on two long-term verbal episodic memory tasks, on an abstract reasoning task and on three measures of executive functioning. The MiD patients' performances on the same tests fell between those of the other two groups of PD patients but did not show significant differences. Our results indicate that MD in PD is associated with a qualitatively specific neuropsychological profile that may be related to an alteration of prefrontal and limbic cortical areas. Moreover, the same data suggest that in these patients MiD and MD may represent a gradual continuum associated with increasing cognitive deficits.

Compression neuropathies of the lower extremity

Compression neuropathies of the lower extremity can be just as disabling as compression neuropathies in the upper extremity. The most common compression neuropathies encountered in the lower extremity affect the lateral femoral cutaneous nerve, the peroneal nerve, the saphenous nerve, the sural nerve, and the tibial nerve (including their branches). These are discussed in terms of anatomy, etiologies, manifestations, and surgical treatment.