Skeletal Radiology

, Volume 48, Issue 5, pp 807–812 | Cite as

Partial anterior tunnel syndrome: a retrospective analysis of ultrasound findings in four surgically proven cases

  • Stefano BianchiEmail author
  • Laure Droz
  • Thomas Le Corroller
  • Marino Delmi
Case Report


We present the cases of four patients (two men and two women, mean age of 48.5 years) with surgically confirmed partial anterior tarsal syndrome, diagnosed by ultrasound. All patients reported pain in the dorsal aspect of the forefoot radiating to the first intermetatarsal space. Ultrasound showed compression of the medial branch of the deep fibular nerve by the extensor hallucis brevis tendon at the level of the Lisfranc joint, associated with a hypoechoic neuroma. The ultrasound allowed a correct diagnosis to be obtained, which was not evident from clinical examination or by standard radiographs (four patients) or MRI (three patients). Surgery confirmed the sonographic findings, and all patients showed complete recovery.


Ultrasound Deep fibular nerve Anterior tarsal syndrome Nerve compression Ankle 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


  1. 1.
    Bianchi S. Ultrasound of the peripheral nerves. Joint Bone Spine. 2008;75(6):643–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Bianchi S, Draghi F, Beggs I. Ultrasound of the peripheral nerves. In: Allan PL, Baxter GM, Weston MJ, editors. Clinical ultrasound. 2nd ed. Philadelphia: Churchill Livingstone Elsevier; 2011. p. 1158–93.CrossRefGoogle Scholar
  3. 3.
    Créteur V, Bacq C, Fumière E, et al. Sonography of peripheral nerves. Part II: lower limbs. J Radiol. 2007;88:349–60.CrossRefPubMedGoogle Scholar
  4. 4.
    Jacobson JA, Wilson TJ, Yang LJ. Sonography of common peripheral nerve disorders with clinical correlation. J Ultrasound Med. 2016;35(4):683–93.CrossRefPubMedGoogle Scholar
  5. 5.
    De Maeseneer M, Madani H, Lenchik L, et al. Normal anatomy and compression areas of nerves of the foot and ankle: US and MR imaging with anatomic correlation. Radiographics. 2015;35(5):1469–82.CrossRefPubMedGoogle Scholar
  6. 6.
    Yablon CM, Hammer MR, Morag Y, Brandon CJ, Fessell DP. Jacobson JA. US of the peripheral nerves of the lower extremity: a landmark approach. Radiographics. 2016;36(2):464–78.CrossRefPubMedGoogle Scholar
  7. 7.
    Bianchi S, Droz L, Lups Deplaine C, Dubois Ferriere V, Delmi M. Ultrasound of the sural nerve: normal and pathological appearance. A pictorial essay. J Ultrasound Med. 2017.
  8. 8.
    Petrover D, Bellity J, Vigan M, Nizard R, Hakime A. Ultrasound imaging of the thenar motor branch of the median nerve: a cadaveric study. Eur Radiol. 2017.
  9. 9.
    Andresen BL, Wertsch JJ, Stewart WA. Anterior tarsal tunnel syndrome. Arch Phys Med Rehabil. 1992;73(11):1112–7.PubMedGoogle Scholar
  10. 10.
    Borges LF, Hallett M, Selkoe DJ, Welch K. The anterior tarsal tunnel syndrome. Report of two cases. J Neurosurg. 1981;54(1):89–92.CrossRefPubMedGoogle Scholar
  11. 11.
    Krause KH, Witt T, Ross A. The anterior tarsal tunnel syndrome. J Neurol. 1977;217(1):67–74.CrossRefPubMedGoogle Scholar
  12. 12.
    Bianchi S, Martinoli C. The foot. Chapter 17. In: Bianchi S, Martinoli C, editors. Ultrasound of the musculoskeletal system. Berlin: Springer; 2007. p. 835–86.CrossRefGoogle Scholar
  13. 13.
    Donovan A, Rosenberg ZS, Cavalcanti CF. MR imaging of entrapment neuropathies of the lower extremity. Part 2. The knee, leg, ankle, and foot. Radiographics. 2010;30(4):1001–19.CrossRefPubMedGoogle Scholar
  14. 14.
    Liu Z, Zhou J, Zhao L. Anterior tarsal tunnel syndrome. J Bone Joint Surg (Br). 1991;73(3):470–3.CrossRefGoogle Scholar
  15. 15.
    Logullo F, Ganino C, Lupidi F, Perozzi C, Di Bella P, Provinciali L. Anterior tarsal tunnel syndrome: a misunderstood and a misleading entrapment neuropathy. Neurol Sci. 2014;35(5):773–5.PubMedGoogle Scholar
  16. 16.
    Lawrence SJ, Botte MJ. The deep peroneal nerve in the foot and ankle: an anatomic study. Foot Ankle Int. 1995;16(11):724–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Marinacci AA. Neurological syndromes of the tarsal tunnels. Bull Los Angel Neurol Soc. 1968;33:90–1.Google Scholar
  18. 18.
    Sillat T, Pivec C, Bernathova M, Moritz T, Bodner G. Unusual cause of anterior tarsal tunnel syndrome: ultrasound findings. J Ultrasound Med. 2017;36(4):837–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Reed SC, Wright CS. Compression of the deep branch of the peroneal nerve by the extensor hallucis brevis muscle: a variation of the anterior tarsal tunnel syndrome. Can J Surg. 1995;38(6):545–6.PubMedGoogle Scholar
  20. 20.
    Dellon AL. Deep peroneal nerve entrapment on the dorsum of the foot. Foot Ankle. 1990;11(2):73–80.CrossRefPubMedGoogle Scholar
  21. 21.
    Knackfuss IG, Giordano V, Nogueira M, Giordano M. Compression of the medial branch of the deep peroneal nerve, relieved by excision of an os intermetatarseum. A case report. Acta Orthop Belg. 2003;69:568e570.Google Scholar
  22. 22.
    Lindenbaum BL. Ski boot compression syndrome. Clin Orthop. 1979;140:109–10.Google Scholar
  23. 23.
    Tennant JN, Rungprai C, Phisitkul P. Bilateral anterior tarsal tunnel syndrome variant secondary to extensor hallucis brevis muscle hypertrophy in a ballet dancer: a case report. Foot Ankle Surg. 2014;20(4):e56–8.CrossRefPubMedGoogle Scholar
  24. 24.
    Gani N, Khan HA, Kamal Y, Farooq M, Jeelani H, Shah AB. Anterior tarsal tunnel syndrome with thrombosed dorsalis pedis artery: a case report. Arch Trauma Res. 2015;4(1):e21738.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Kanbe K, Kubota H, Shirakura K, Hasegawa A, Udagawa E. Entrapment neuropathy of the deep peroneal nerve associated with the extensor hallucis brevis. J Foot Ankle Surg. 1995;34(6):560–2.CrossRefPubMedGoogle Scholar

Copyright information

© ISS 2018

Authors and Affiliations

  • Stefano Bianchi
    • 1
    Email author
  • Laure Droz
    • 2
  • Thomas Le Corroller
    • 3
    • 4
  • Marino Delmi
    • 5
  1. 1.CIM SA, Cabinet Imagerie MédicaleGenevaSwitzerland
  2. 2.GenevaSwitzerland
  3. 3.APHM, Hôpital Sainte MargueriteMarseilleFrance
  4. 4.ISM, UMR 7287 CNRS et Aix-Marseille UniversitéMarseille Cedex 09France
  5. 5.Clinique des GrangettesChêne-BougeriesSwitzerland

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