What would a positive Tinel’s sign at the ankle suggest?

• A. Tarsal tunnel syndrome due to tibial nerve compression.
• B. Ankle sprain or strain.
• C. Fracture of the calcaneus.
• D. Plantar fasciitis.

Answer: (A)

A positive Tinel's sign at the ankle indicates irritation or compression of the tibial nerve, which is a hallmark of tarsal tunnel syndrome. This test involves tapping over the location of the nerve, and when a positive sign is elicited, it typically results in tingling, numbness, or pain along the distribution of the nerve, particularly into the sole of the foot.

In the context of tarsal tunnel syndrome, the tibial nerve and its branches can become compressed in the tarsal tunnel, leading to sensory disturbances. Therefore, a positive Tinel’s sign serves as a strong indicator of this condition, confirming the diagnosis based on the clinical presentation of nerve irritation.

The other options, such as ankle sprain or strain, fracture of the calcaneus, and plantar fasciitis, do not specifically involve nerve irritation that Tinel's sign tests for. Ankle sprains and strains are associated with damage to ligaments and muscles rather than nerve compression, while fractures involve bone integrity and would typically not be assessed with Tinel's sign. Plantar fasciitis primarily manifests as heel pain and stiffness and is not related to nerve compression, again making the applicability of Tinel's sign irrelevant in those cases.