40 year old male with shooting type of pain in the lower leg Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

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Presentation transcript:

40 year old male with shooting type of pain in the lower leg Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology

Vignette 40 year old male with shooting type of pain in the right lower leg Patient had history of penetrating trauma to medial aspect of the right lower leg 3 years back. On examination, patient had a cutaneous scar at the site of previous injury and a small nodule palpable beneath the cutaneous-scar. © 2013 American Academy of Neurology Sathya Narayanan et al.

© 2013 American Academy of Neurology Imaging

Sathya Narayanan et al. © 2013 American Academy of Neurology Imaging

Post traumatic neuroma in continuity of the right tibial Nerve Post-traumatic neuromas are divided into neuroma-in- continuity and end-bulb-neuroma Neuroma-in-continuity is fusiform thickening of nerve due to injury or chronic friction of intact nerve. End-bulb-neuroma occurs in completely transected nerve which is not in apposition with distal nerve Perineural-fibrosis, T2-hypointensity and absence of contrast enhancement differentiate neuroma-in-continuity from nerve-sheath- tumors. Sathya Narayanan et al. © 2013 American Academy of Neurology