Presentation
Painless/ atraumatic right foot drop. Nerve conduction test positive for peroneal neuropathy. Referred for peroneal nerve ultrasound.
Patient Data
The common peroneal nerve shows a fusiform, homogeneously hypoechoic lesion (12 x 3 x 3 mm) at the fibular head level. There is no cystic spaces/calcification/vascularity in the lesion. The lesion is located in the lateral side of the nerve in short-axis images. Medial fascicles of the nerve are normal. The rest of the common peroneal nerve reveals normal echopattern without perineural or other neural lesions.
The superficial peroneal nerve and the deep peroneal nerve are normal from their origin to the ankle level.
The anterior compartment of the leg muscles show reduced bulk and severely increased echogenicity. The lateral compartment of the leg muscles shows normal bulk and echogenicity.
Case Discussion
A girl developed a painless right foot drop three years prior to the presentation. Previous brain and spine MRI studies were normal (no copyright, not uploaded).
Recent nerve conduction test suggested common peroneal neuropathy. Tinel’s sign was positive at the fibular head. Ultrasound shows an eccentrically located soft tissue lesion in the common peroneal nerve. Secondary muscle changes are limited to the anterior compartment of the leg which favors the involvement of the deep peroneal nerve fascicles of the common peroneal nerve.
Clinical examination and nerve conduction test courtesy: treating neuro physician Dr. Roshan Patel
Unable to process the form. Check for errors and try again.