Calcaneal osteomyelitis presenting with acute tarsal tunnel syndrome: a case report

<p>Abstract</p> <p>Introduction</p> <p>Cases of acute tarsal tunnel syndrome are rare. To the best of our knowledge, we describe the only reported case of acute posterior tibial nerve compression resulting from adjacent haemotogenous pyogenic calcaneal osteomyelitis.</p> <p>Case presentation</p> <p>A previously healthy 38-year-old Caucasian woman developed symptoms of acute tarsal tunnel syndrome in her right foot over a six-day period. No antecedent trauma or systemic symptoms were noted. Magnetic resonance imaging and bone scan imaging, followed by surgical decompression and bone biopsy confirmed a diagnosis of <it>Staphylococcus aureus </it>calcaneal osteomyelitis. Her pain and paraesthesia disappeared after the operation, while her inflammatory markers normalised during a 12-week course of antibiotics. After four years she has remained asymptomatic without any indication of recurrence.</p> <p>Conclusion</p> <p>This case is not just unique in describing osteomyelitis as a cause of tarsal tunnel syndrome, because haemotogenous calcaneal osteomyelitis is in itself a rare pathology. We recommend considering infection as a differential diagnosis in patients presenting with acute tarsal tunnel syndrome.</p

Impact of the California Lead Ammunition Ban on Reducing Lead Exposure in Golden Eagles and Turkey Vultures

Predatory and scavenging birds may be exposed to high levels of lead when they ingest shot or bullet fragments embedded in the tissues of animals injured or killed with lead ammunition. Lead poisoning was a contributing factor in the decline of the endangered California condor population in the 1980s, and remains one of the primary factors threatening species recovery. In response to this threat, a ban on the use of lead ammunition for most hunting activities in the range of the condor in California was implemented in 2008. Monitoring of lead exposure in predatory and scavenging birds is essential for assessing the effectiveness of the lead ammunition ban in reducing lead exposure in these species. In this study, we assessed the effectiveness of the regulation in decreasing blood lead concentration in two avian sentinels, golden eagles and turkey vultures, within the condor range in California. We compared blood lead concentration in golden eagles and turkey vultures prior to the lead ammunition ban and one year following implementation of the ban. Lead exposure in both golden eagles and turkey vultures declined significantly post-ban. Our findings provide evidence that hunter compliance with lead ammunition regulations was sufficient to reduce lead exposure in predatory and scavenging birds at our study sites