Isolated Peroneus Longus Tear - Commonly Missed Diagnosis of Lateral Ankle Pain: A Case Report

@#Peroneal tendon tear is a relatively common cause of lateral ankle pain but often missed due to mixed presentation or low index of suspicion. Left untreated, peroneal injuries can lead to persistent ankle pain, instability and ultimately substantial functional disabilities. An isolated peroneus longus tear is rare with the lowest incidence rate compared to isolated peroneus brevis tear and mixed tear of both peroneal tendon. This is a case report of a 49-year-old lady with a chronic left ankle pain who ultimately underwent surgery for an isolated peroneus longus tear.

You can never have too many accessories - a case of two accessory muscles of the ankle

Accessory muscles are relatively rare anatomic duplications of muscles that may appear anywhere in the muscular system. Though a wide array of accessory and supernumery muscles involving the ankle have been described in the literature, this is the first reported case we are aware of that features two accessory muscles. Accessory muscles are typically asymptomatic and often picked up as incidental findings but are important to be identified in the presence of chronic persistent ankle pain and the absence of other more common aetiologies.

Non operative treatment of chronic ankle sprain: a study conducted in teaching general hospital, Telangana, India.

Background: Chronic ankle sprain due to “sprained ankle syndrome” may be particularly troublesome. Some causes of chronic ankle instability may be symptomatic insufficiency of pathologic laxity, arthro-kinematic changes, degenerative changes, decrease of proprioception and inadequate neuromuscular control. This study was conducted to review our experience with footwear correction of chronic ankle sprains of grade 2 and 3. Methods: Ankles of 280 patients, who had chronic ankle sprains grade 2, grade 3 were considered in this study, to assess results of non-operate treatment. Diagnosis was made with history of pain, swelling on walking, clinical findings of swelling, tenderness on antero-lateral aspect of lateral malleolus. All patients were given 3 days of anti-inflammatories, analgesics and footwear modifications. Later patients were advised exercise program. Results: Out of 280 patients, who were regularly followed, 92% people had relief, 3.4% of patients continued footwear as they had associated symptoms, 3.9% of patient continued to have pain maybe obscure or not following doctor orders. Conclusion: The study concludes that lateral elevated foot wear made of micro cellular rubber of 0.75 cm is the choice of treatment for grade 2 and 3 ankle sprains. This foot wear helps in biomechanical correction from varus and also decreases symptoms and signs. Cosmetically acceptable.

Plantar fasciitis: corticosteroid injection versus chiropractic therapy.

The diagnosis of plantar fasciitis is usually clinical and rarely needs to be investigated further. The patient complains of pain in the medial side of the heel, most noticeable with initial steps after a period of inactivity and usually lessens with increasing level of activity during the day, but will tend to worsen toward the end of the day. Symptoms may become worse following prolonged weight bearing, and often precipitated by increase in weight bearing activities. Paresthesia is uncommon. It is usually unilateral, but up to 30% of cases have a bilateral presentation. In our study patients who received chiropractic therapy were treated by rest, heat, ice pack, non-steroidal anti-inflammatory drugs (NSAIDS), heel pads, magnetic insole, night splints, walking cast, taping, ultrasound, plantar and Achilles stretching for a period of 6 weeks scheduled accordingly. Patients receiving corticosteroid injection were administered 80mg methyl prednisolone locally at the heel. Each patient received 3 doses of methyl prednisolone injections on 1st day, 2nd week, and 4th week. The results with corticosteroid injection were better when analyzed with numeric rating scale over a period of 6 weeks.

Caso clínico: resección artroscópica de osteoma osteoide de cuello del talo / Arthoscopic excision of an osteoid osteoma at the talar neck

The case of a 17-year-old boy with osteoidosteoma of the talar neck with a 2-year history of persistent ankle pain is presented. The diagnosis was made on the basis of clinical appearance, radiography, CT scan, technetium-99m scintigraphy, and magnetic resonance imaging findings. He underwent arthroscopic excision of the lesion using a motorized trefina and radiofrequency ablation. The pathological study of the arthroscopic excision confirm the preoperative diagnosis. He ad no recurrence during a follow-up period of 24 months. We concluded that the arthroscopic excision of an osteoid osteoma on the talar neck is an appropriate surgical intervention and an excellent therapeutical choice.

Se presenta el caso de un paciente de 17 años con un osteoma osteoide del cuello del talo que presentaba una historia de dolor persistente de tobillo de 2 años de evolución. El diagnóstico se realizó en base a la historia clínica y a los hallazgos imagenológicos en radiografía, TAC, cintigrama óseo (tecnecio-99) y resonancia magnética. Se realizó un abordaje artroscópico de la lesión, siendo resecada en forma completa con trefina motorizada y ablación por radiofrecuencia en los bordes del lecho óseo. El resultado anatomopatológico confirmó el diagnóstico preoperatorio. La evolución del paciente ha sido satisfactoria a 24 meses de seguimiento. Concluimos que la resección artroscópica de un osteoma osteoide de cuello de talo es un procedimiento recomendable y una excelente alternativa terapéutica.