Postoperative common peroneal nerve (CPN) entrapment is a common iatrogenic cause of foot drop, and an established rehabilitation protocol is currently lacking. This article provides a step-by-step visual demonstration of an integrated approach, combining ultrasound-guided hydrodissection with structured task-oriented rehabilitation. The protocol includes: (1) real-time ultrasound identification of CPN entrapment; (2) in-plane, multi-quadrant hydrodissection using a 5% dextrose, lidocaine, and mecobalamin injectate; and (3) a phased rehabilitation program initiated 24 h post procedure, comprising neural gliding, therapeutic ultrasound, neuromuscular electrical stimulation, and five task-oriented training modules. In the representative case, the leg-foot angle during maximal dorsiflexion effort demonstrated a 38° reduction (from 142° to 104°), and gait analysis showed restoration of heel-strike, push-off, and swing-phase foot clearance. Post-intervention EMG revealed reinnervation potentials in the tibialis anterior, peroneus longus, and extensor hallucis longus. This visually formatted, stepwise protocol demonstrates the feasibility of combining percutaneous nerve decompression with task-specific rehabilitation, offering a replicable framework for managing refractory postoperative CPN entrapment.

Foot and ankle injections are commonly performed by family physicians for the management of musculoskeletal conditions such as plantar fasciitis, osteoarthritis, interdigital neuromas, tarsal tunnel syndrome, and pathology of the first metatarsophalangeal joint. If symptoms persist despite conservative measures, injections may improve function and reduce pain. Before an injection, the clinician should discuss procedural risks, including pain, swelling, redness, stiffness, infection, and damage to surrounding tissues, and obtain informed consent. Corticosteroid injections can provide short-term pain relief for plantar fasciitis and first metatarsophalangeal joint arthritis, but they increase the risk of fascia rupture, fat pad atrophy, and cartilage damage. Platelet-rich plasma injections are supported by evidence that they may be beneficial in those with plantar fasciitis. Corticosteroid injections placed directly into weight-bearing tendons is not recommended because of the increased risk of rupture. Ultrasound guidance improves accuracy and reduces procedural risks such as neurovascular injury.

Background: Carpal tunnel syndrome (CTS) is the most prevalent peripheral nerve entrapment neuropathy, with rising incidence in aging populations. Uncertainty persists regarding the efficacy and safety of carpal tunnel release (CTR) in patients aged ≥ 70 years. Objectives: To systematically evaluate the indications, clinical outcomes, and utility of CTR in elderly patients (≥70 years), with comparison to younger cohorts. Methods: Following PRISMA 2020 guidelines, PubMed/MEDLINE, Scopus, CENTRAL, Embase, Web of Science, and grey literature sources were searched from inception through September 2025. Two independent reviewers extracted data; inter-rater agreement was strong (κ = 0.81-0.86). The primary outcome was the Boston Carpal Tunnel Questionnaire (BCTQ). Weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated using DerSimonian-Laird random-effects models. Certainty of evidence was assessed using the GRADE framework. Results: A total of 20 studies encompassing 3841 operated hands, including 1139 hands in elderly patients and 2702 hands in younger comparators across comparative studies, were analyzed. Mean SS-BCTQ improvement was 1.8 points (95%CI: 1.6-2.0; exceeding the established MCID of 1.04-1.05 points). FS-BCTQ improvement was 1.1 points (95%CI: 0.9-1.3; marginally below the pooled MCID of 1.13 points). Elderly patients demonstrated SS-BCTQ improvement of 1.7 points and satisfaction rates of 72-94%, comparable to younger cohorts (75-95%; p = 0.38). Grip strength improved 15-25% in younger patients but remained unchanged in elderly patients (p < 0.001). Sensory recovery reached 42% in elderly versus 58% in younger patients (p < 0.01). Complication rates were low and age-independent (3.1%; RR 1.08; 95%CI: 0.86-1.35; p = 0.52). GRADE certainty was as follows: low for symptom and functional improvement; very low for surgery versus conservative management. Conclusions: CTR is associated with significant symptomatic benefit in elderly patients when conservative treatment fails, with complication rates comparable to younger populations. Age alone should not constitute a surgical contraindication. Preoperative counseling must establish realistic expectations regarding grip strength and functional recovery. High-quality randomized trials in elderly populations remain an urgent research priority.

This report discusses a patient in his late 60s with a diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA) who was found to have radiological periaortitis. He presented with acute mononeuritis multiplex and constitutional symptoms. Investigations revealed marked eosinophilia, positive myeloperoxidase (MPO) antibodies and imaging evidence of periaortitis. Nerve conduction studies showed axonal mononeuropathies, and a sural nerve biopsy confirmed a vasculitic neuropathy with eosinophilic infiltrates. He was treated with high-dose corticosteroids and intravenous cyclophosphamide, with substantial neurological improvement, and later transitioned to maintenance azathioprine. His course was complicated by a pulmonary embolism. Radiological follow-up demonstrated remission of periaortitis. This case emphasises the diagnostic challenges of distinguishing EGPA from mimics such as IgG4-related disease and highlights the importance of recognising rare large-vessel involvement in EGPA and underlines the need for vigilance regarding thromboembolic complications.

The causal relationship between instant coffee consumption and carpal tunnel syndrome (CTS) remains unclear. This study aimed to investigate the potential causal association between instant coffee consumption and CTS using data from large-scale genome-wide association studies, thereby providing genetic epidemiological evidence on this association. This study selected single nucleotide polymorphisms strongly associated with instant coffee consumption as instrumental variables. A 2-sample Mendelian randomization (MR) design was used. Three MR analysis methods were used: inverse variance weighted, MR-Egger regression, and weighted median to assess potential causal relationships. Cochran's Q test was used to evaluate heterogeneity in the data. Summary statistics were derived from 1,80,764 individuals for instant coffee consumption and 4,80,201 individuals for CTS, all of European ancestry, to minimize bias from population stratification. Sensitivity analyses were performed using the leave-one-out method to validate the robustness of the results. The inverse variance weighted results showed that the odds ratio of CTS with respect to instant coffee consumption was 3.41 (95% confidence interval: 1.65-7.04, P = .0009), suggesting a significant positive causal relationship between instant coffee consumption and CTS. Sensitivity analyses did not reveal significant heterogeneity and horizontal pleiotropy (P > .05). This study suggested a potential positive causal association between instant coffee consumption and CTS using the 2-sample MR approach, although the findings should be considered preliminary and hypothesis-generating.