Dropped

A 48 year old man presents with pain and discomfort over the dorsum of the left foot and the front of the left leg just below the knee, for 5 weeks. He was also unable to extend the foot over the last few days.

He gives a history of intermittent discomfort, pain, and paraesthesia in the same area for six years, which responded to physiotherapy and analgesics. There was no history of trauma.

Select Relevant Investigations
Electromyography

Performed

Shows denervation of the L/tibialis anterior and peroneus longus muscles
Nerve conduction studies

Performed

L/common peroneal nerve: delayed latency and reduction of amplitude suggestive of a compressive lesion distal to the head of the fibula
L/tibial and Sural nerves: conduction velocity is within normal limits
MRI L/Leg

Performed

The common peroneal nerve is compressed by a 12 mm x 10 mm mass anterolateral to the fibula and 2.5 cm distal to the head of the fibula
X-ray Ankle Joint

Performed

The x-ray appears normal

Select Relevant Management
Surgical referral
NSAIDs
Physiotherapy
Nerve grafting