Granular cell tumor of peripheral nerves is extremely rare. We present the case of a patient with a well-capsulated intraneural granular cell tumor involving the posterior tibial nerve, who presented with chronic heel pain mimicking plantar fasciitis. Magnetic resonance imaging revealed a well-defined intraneural soft-tissue mass within the substance of the posterior tibial nerve. Histopathologic examination showed a granular cell tumor, which is extremley rare in the peripheral nerves. Heel pain is one of the common conditions handled by physicians, podiatrists, and orthopedic surgeons. Posterior tibial nerve lesions at the leg should be kept in mind in the differential diagnosis of patients with persistent heel and foot pain. Magnetic resonance imaging is a useful method in the anatomical evaluation of focal intraneural lesions. (J Am Podiatr Med Assoc 99(3): 254–257, 2009)
Background: To determine the effectiveness of four different local injection modalities in the treatment of plantar fasciitis.
Methods: In a prospective randomized multicenter study of plantar fasciitis, 100 patients were divided into four equal groups and were treated using four different methods of local injection: group A was treated with 2 mL of autologous blood alone; group B, an anesthetic (2 mL of lidocaine) combined with peppering; group C, a corticosteroid (2 mL of triamcinolone) alone; and group D, a corticosteroid (2 mL of triamcinolone) combined with peppering. The outcome was defined by using a 10-cm visual analog scale and modified criteria of the Roles and Maudsley score 3 weeks and 6 months after the injection and compared with the pretreatment condition.
Results: The successful results in all of the groups after injections were higher than those in the pretreatment condition (P = .000). In groups C and D, in which local corticosteroid injections were used, excellent results were obtained, with superior effect in the group in which peppering was used (P < .05).
Conclusions: In the treatment of plantar fasciitis, combined corticosteroid injections and peppering is effective and produces better clinical results. (J Am Podiatr Med Assoc 99(2): 108–113, 2009)
Lipoma arborescens is an uncommon pseudotumoral synovial lesion usually located in the suprapatellar pouch of the knee. Lipoma arborescens involving the synovial sheaths of the tendons is exceedingly rare. This diagnosis should be considered, particularly in patients with chronic joint effusion. We report a case with lipoma arborescens affecting the synovial sheaths of the peroneal tendons without involvement of the adjacent ankle joint. To our knowledge, this is the second reported case of lipoma arborescens involving tenosynovial sheaths of tendons arround the ankle joint without ankle joint involvment. (J Am Podiatr Med Assoc 99(2): 153–156, 2009)