Tarsal Tunnel Varicosities: MRI

Patient presented with tunnel sign and compression test positivie. MRI revealed varicosties  in relation to the tarsal tunnel in relation to the flexor digitorum longus & flexor hallucis, needs clinical correlation for tarsal tunnel symptoms.

Perhaps one of the greatest values of MRI in evaluating suspected tarsal tunnel syndrome is its potential to document varicosities or dilated veins within the tarsal tunnel.  Venous insufficiency is often a contributing factot to tarsal tunnel syndrome and tarsal tunnel decompression surgery often includes ligation of enlarged, tortuous veins 

MR imaging can accurately depict the contents of the tarsal tunnel, including the posterior tibial nerve and its terminal branches. Pathological entities affecting these neural structures including soft tissue masses, varicosities, fibrosis, tendon sheath thickening and tenosynovitis, as well as secondary intrinsic changes such as swelling and inflammation, can be readily identified.