Tarsal tunnel syndrome masked by painful diabetic polyneuropathy

•The real cause of symptoms in patients with neuropathy may not be related with diabetes.•It is essential to investigate the etiology of the disease with more localized pathologies in such complicated cases.•Tarsal tunnel syndrome gives a more segmental clinical profile with nerve entrapment.

IntroductionVarious causes influence the etiology of tarsal tunnel syndrome including systemic diseases with progressive neuropathy, such as diabetes.Presentation of caseWe describe a 52-year-old male patient with complaints of numbness, burning sensation and pain in both feet. The laboratory results showed that the patient had uncontrolled diabetes, and the EMG showed distal symmetrical sensory-motor neuropathy and nerve entrapment at the right. Ultrasonography and MRI showed the cyst in relation to medial plantar nerve, and edema- moderate atrophy were observed at the distal muscles of the foot.DiscussionFoot neuropathy in diabetic patients is a complex process. So, in planning the initial treatment, medical or surgical therapy is selected based on the location and type of the pathology. Foot deformities can be corrected with resting, anti-inflammatory treatment, appropriate shoes, orthesis and socks, and if required, ankle stabilization can be attempted. If the patient is still unresponsive, surgical treatment may be applied.ConclusionIt is essential to investigate more localized reasons like tarsal tunnel syndrome that may mimic diabetic neuropathy, should be treated primarily.