E4863. Don't be a Nervous Wreck: A Guide to the Tarsal Tunnel
  1. Chukwuemeka Okoro; University of California, Los Angeles
  2. Kambiz Motamedi; University of California, Los Angeles
  3. Varand Ghazikhanian; University of California, Los Angeles
The tarsal tunnel is a commonly encountered location identified as a source of pain in patients with foot pain. As MRI continues to become widely adopted and utilized, radiologists are increasingly encountering associated pathology that needs to be further described and characterized.

Educational Goals / Teaching Points
The aim of this educational exhibit is to provide a review of the anatomy of the tarsal tunnel and define the anatomic relationships to other ankle structures and to discuss the associated pathology, such as tarsal tunnel syndrome.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit will review MRI and gross pathology features of the posterior tibial neurovascular bundle, tibialis posterior tendon, flexor digitorum longus, and flexor hallucis longus within the tarsal tunnel. For each tarsal tunnel structure, key distinguishing features, including common anatomic location and clinical presentations, will be emphasized. Additionally, appropriate follow up will be reviewed with treatment options, including nerve blocks, tarsal tunnel injection/aspiration, and surgical considerations.

The tarsal tunnel is a narrow osteofibrous space in the posterior to the medial ankle formed between the posterior medial malleolus, talus, calcaneus, and the overlying flexor retinaculum. This educational exhibit will familiarize learners with the typical imaging features of the space, assisted by the pathologic specimen correlation, as well as recognizing the clinical significance of identifying the precise location of mass lesions within the tarsal tunnel that will inform image-guided interventions and/or surgical approaches. In an era of increased dependence on MRI, this knowledge should be a part of every radiologist's skillset to allow for an accurate diagnosis and to help decrease unnecessary follow-up studies or procedures.