Patient thinks monofilaments are touching opposite foot
Hi all - I'm looking for some advice please from my more experienced readers......
I assessed a 65 year old male with bilateral ball of foot pain, which shoots into his toes during gait. He has no significant medical hx or current rx. He started with these pain symptoms almost suddenly, three years ago.
Mechanically, he has pes planus and genu vara bilat, but he has never had foot or lower limb pain before.
However.........................
When performing the 10g monofilament tests (with his eyes closed) he states all locations correctly on his left foot. However, every location I touch on his right foot, is reported correctly by him in terms of location, but he remarks that he is feeling it on his left foot!
(Once his eyes are open, he can see the monofilament touching his right foot, and only then does he sense the touch to the right foot.)
He has been to two neurophysiologists since 2008 who report his nerve conductivity tests are normal. He has been to consultant physicians on five occasions over the past three years and has been told he has no signs (or serology confirmation) of diabetes mellitus.
He has also seen an orthopaedic surgeon (last month) who worked in tandem with another neurophysiologist who concluded he doesn't have tarsal tunnel syndrome, PN or post-tib dysfunction.
I look forward to any help!
Thanks
Last edited by Kahuna : 20th May 2010 at 03:34 PM.
Reason: typo
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