Lateral plantar nerve injury following steroid injection

The last muscle to demonstrate evidence of reinnervation during recovery for a radial nerve palsy is the extensor indicis proprius.

Abrams et al dissected 20 cadavers to identify the motor branches of the radial nerve. They determined the innervation order from proximal to distal was brachioradialis, extensor carpi radialis longus, supinator, extensor carpi radialis brevis, extensor digitorum communis, extensor carpi ulnaris, extensor digiti quinti, abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis, and extensor indicis proprius (Illustration A).

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The sinus tarsi, or talocalcaneal sulcus, is an anatomic space bound by the calcaneus, talus, talocalcaneonavicular joint, and posterior facet of the subtalar joint. Pain from this location is usually felt in the lateral calcaneus and ankle, and is worse immediately following exercise and when walking on an uneven surface. 24 It can arise from repeated lateral ankle sprains or from repeated hyperpronation of the foot. 24 Initial treatment includes managing the underlying causes with orthotics or physical therapy, although anti-inflammatory or analgesic medications and corticosteroid injections ( Figure 6 ) may also be beneficial.

Patients may be unaware of their loss of some or all distal sensation; sensory loss may present as degrees of numbness, paraesthesia or hyperalgesia. The patient should lie relaxed on a couch throughout the assessment, and not watch the tests, in order to avoid visual prompts. Sensory evaluation should be carried out in a systematic manner, with all areas of the foot and all sensory modalities assessed. The distribution of altered sensation (. dermatomal loss; distal loss) is noted on an appropriate form retained within the patient's case notes. Where possible the same clinician should carry out any repeat tests, and repeat tests, . every 6-12 months should be made at the same time of day as the original assessment, due to the diurnal variation in sensory awareness.

Lateral plantar nerve injury following steroid injection

lateral plantar nerve injury following steroid injection

Patients may be unaware of their loss of some or all distal sensation; sensory loss may present as degrees of numbness, paraesthesia or hyperalgesia. The patient should lie relaxed on a couch throughout the assessment, and not watch the tests, in order to avoid visual prompts. Sensory evaluation should be carried out in a systematic manner, with all areas of the foot and all sensory modalities assessed. The distribution of altered sensation (. dermatomal loss; distal loss) is noted on an appropriate form retained within the patient's case notes. Where possible the same clinician should carry out any repeat tests, and repeat tests, . every 6-12 months should be made at the same time of day as the original assessment, due to the diurnal variation in sensory awareness.

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