Validity of Tinel sign and prevalence of tibial nerve entrapment at the tarsal tunnel in both diabetic and non-diabetic subjects: a cross-sectional study

Background: Nerve entrapments like carpal tunnel syndrome are more prevalent in patients with diabetes, especially in those with diabetic polyneuropathy. Our study aim was to investigate the validity of the Tinel sign in diagnosing tibial neuropathy and determine the prevalence of tibial nerve entrapment in both a diabetic and non-diabetic population. Methods: 240 non-neuropathic subjects with diabetes and 176 diabetic subjects with neuropathy participating in the prospective Rotterdam Diabetic Foot Study and 196 reference subjects without diabetes and without neuropathy complaints were evaluated. All subjects underwent sensory testing of the feet and complaints were assessed using the Michigan Neuropathy Screening Instrument. The Tinel sign was defined as discriminative valid to diagnose tibial nerve entrapment when the nerve related MNSI sub-score of neuropathic symptoms differed at least 5% between the Tinel positive and Tinel negative subjects. When valid, prevalence estimates of tibial nerve entrapment at the tarsal tunnel were calculated. Results: Significantly more neuropathic symptoms (p

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