A rare case of an acute soleus arcade syndrome complicated by a ganglion cyst: diagnosis by dynamic ultrasound

Leonhard Gruber, Alexander Loizides, Stephanie Klien, Thomas Trieb, Michael Koller, Wolfgang Löscher, Hannes Gruber

Abstract


The soleus arcade syndrome is a rare compression neuropathy of the tibial nerve that often remains undiagnosed due to low clinical awareness and difficult diagnosis. We present the case of a female patient admitted with acute worsening of a pre-existing sensory tibial neuropathy and acute tibial nerve palsy after knee joint injection. After a knee magnetic resonance imaging remained non-diagnostic, dynamic ultrasonography was performed. Constriction by the soleus arcade and proximal swelling of the tibial nerve could be demonstrated during plantarflexion of the ankle by means of a dynamic examination in the standing patient. The patient underwent surgery and recovered fully. This proposed diagnostic approach can be used to identify soleus arcade syndrome by ultrasound.


Keywords


soleus arcade syndrome; tibial nerve; ganglion cyst; dynamic ultrasonography

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DOI: http://dx.doi.org/10.11152/mu-1003

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