Entrapment Neuropathies III: Lower Limb

ABSTRACT

Clinicians frequently encounter compressive neuropathies of the lower extremity. The clinical history and physical examination, along with electrodiagnostic testing and imaging studies, lead to the correct diagnosis. The imaging characteristics of the compression neuropathies can include acute and chronic changes in the nerves and the muscles they innervate. We provide a detailed review of compression neuropathies of the lower extremity with an emphasis on magnetic resonance (MR) imaging characteristics. We discuss the clinical presentation, etiology, anatomical location, and MR imaging appearance of these neuropathies, including the piriformis syndrome, iliacus syndrome, saphenous neuropathy, obturator neuropathy, lateral femoral cutaneous neuropathy (meralgia paresthetica), proximal tibial neuropathy, common peroneal neuropathy, deep peroneal neuropathy, superficial peroneal neuropathy, tarsal tunnel syndrome, Baxter's neuropathy, jogger's foot, sural neuropathy, and Morton's neuroma.

KEYWORDS

Compression neuropathies - entrapment neuropathies - lower extremity

REFERENCES

• 1 Windisch G, Braun E M, Anderhuber F. Piriformis muscle: clinical anatomy and consideration of the piriformis syndrome.  Surg Radiol Anat. 2007;  29(1) 37-45
• 2 Lacour-Petit M C, Lozeron P, Ducreux D. MRI of peripheral nerve lesions of the lower limbs.  Neuroradiology. 2003;  45(3) 166-170
• 3 Hochman M G, Zilberfarb J L. Nerves in a pinch: imaging of nerve compression syndromes.  Radiol Clin North Am. 2004;  42(1) 221-245
• 4 Stoller D W, Rosenberg Z S, Cavalcanti C et al.. Entrapment neuropathies of the lower extremity. In: Stoller DW Magnetic Resonance Imaging in Orthopaedics and Sports Medicine. Philadelphia, PA; Lippincott Williams & Wilkins 2007: 1051-1098
• 5 Kim S, Choi J Y, Huh Y M et al.. Role of magnetic resonance imaging in entrapment and compressive neuropathy—what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 1. Overview and lower extremity.  Eur Radiol. 2007;  17(1) 139-149
• 6 Busis N A. Femoral and obturator neuropathies.  Neurol Clin. 1999;  17(3) 633-653, vii
• 7 Erbay H. Meralgia paresthetica in differential diagnosis of low-back pain.  Clin J Pain. 2002;  18(2) 132-135
• 8 Grothaus M C, Holt M, Mekhail A O, Ebraheim N A, Yeasting R A. Lateral femoral cutaneous nerve: an anatomic study.  Clin Orthop Relat Res. 2005;  437(437) 164-168
• 9 Vieira R L, Rosenberg Z S, Kiprovski K. MRI of the distal biceps femoris muscle: normal anatomy, variants, and association with common peroneal entrapment neuropathy.  AJR Am J Roentgenol. 2007;  189(3) 549-555
• 10 Schon L C, Baxter D E. Neuropathies of the foot and ankle in athletes.  Clin Sports Med. 1990;  9(2) 489-509
• 11 Delfaut E M, Demondion X, Bieganski A, Thiron M C, Mestdagh H, Cotten A. Imaging of foot and ankle nerve entrapment syndromes: from well-demonstrated to unfamiliar sites.  Radiographics. 2003;  23(3) 613-623
• 12 Masciocchi C, Catalucci A, Barile A. Ankle impingement syndromes.  Eur J Radiol. 1998;  27(Suppl 1) S70-S73
• 13 Lau J T, Daniels T R. Tarsal tunnel syndrome: a review of the literature.  Foot Ankle Int. 1999;  20(3) 201-209