Tarsal TunnelClinical case and images provided by Avneesh Chhabra, M.D., Johns Hopkins University School of Medicine, Baltimore, USA

41-year-old woman with heel pain.

• Prior tarsal tunnel release many month ago

• Accessory muscle missed on prior surgery, seen on MRN
• Visualization of high trifurcation and abnormality of all three nerves (MPN, LPN and enlarged nerve) helped the surgeon
• Clarification of calcaneal nerve and plantar nerves to help the surgeon
• Diagnosis - Nerve re-entrapment and prior inadequate tarsal tunnel release

• Surgery performed again to resect the calcaneal nerve
• Consequently improvement in symptoms