One of the most common causes of lateral calf pain and foot drop is a peroneal nerve entrapment.
One of the most common causes of lateral calf pain and foot drop is a peroneal nerve entrapment. Entrapment of the peroneal nerve is typically the result of trauma to the fibular/head neck region. Peroneal nerve compressive neuropathy is the most common nerve entrapment of the lower extremity.
Nerve entrapment can lead to intraneural ischemia, which can result in neuropathic pain. The common peroneal nerve is a branch of the sciatic nerves and then splits into the deep and superficial peroneal nerves. The symptoms of common peroneal nerve entrapment can vary from weakness of ankle dorsiflexion and foot eversion, but also sensory effects with burning and pain in the anterolateral aspect of the lower extremity.
Anatomy of common peroneal nerve Diagnosis of peroneal nerve entrapment is typically made with an MRI or electromyography (EMG). MR neurography can also be used to better evaluate peripheral nerves. An MRN is usually performed on a 3.0 Tesla MRI and will typically use a flexible phased-array surface coil to better conform to anatomical contours.
Treatment of common peroneal nerve entrapment is sometimes treated with a nerve hydrodissection. This involves injection of fluid around the nerve to help decompress the entrapment. There is no standard regarding what to inject around the nerve for a hydrodissection.
In one study, the providers used 5cc of saline with one cc of steroid. There is evidence that shows that the use of D5W instead of normal saline can lead to better pain relief. The typical volume for a nerve hydrodissection is 5 to 10cc.
If you are experiencing symptoms that may be related to ultrasound guided common peroneal nerve hydrodissection, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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