CASE REPORT
Allodynia Relief Post Ultrasonography-guided Dextrose 5% Perineural Hydrodissection for Superficial Peroneal Nerve Entrapment: A Case Report

Superficial peroneal nerve entrapment is a rare neuropathy caused by mechanical compression of the nerve, usually at its exit from the crural fascia, and may be induced by forced foot inversion and plantar flexion. Conservative initial treatment, including steroid injections, physical rehabilitation, appropriate footwear, and surgical decompression, may be indicated in cases refractory to nonoperative options. Ultrasonography-guided dextrose 5% (D5W) perineural hydrodissection is an interventional therapeutic option for peripheral neuropathy caused by nerve entrapment. We present a case demonstrating the efficacy of dextrose 5% hydrodissection for superficial peroneal nerve entrapment.

A 43-year-old female flight attendant with no history of trauma presented with progressive burning, tingling, and pain upon touching the inferolateral third of the leg and dorsum of the foot for 2 months, which was refractory to conservative treatments. Tinel’s sign and allodynia were found approximately 10 cm above the right lateral malleolus, confirming the diagnosis of peroneal nerve entrapment. Ultrasonography-guided neural hydrodissection of the superficial peroneal nerve using 10 mL D5W was performed 3 times at 1-week intervals. Pain and allodynia were rapidly reduced and progressively disappeared after the third injection and 6-month post-procedure follow-up.

Ultrasonography-guided D5W perineural hydrodissection may be a therapeutic option for superficial peroneal nerve entrapment, as three injections performed at 1-week intervals showed quick recovery at the 6-month follow-up with no adverse events reported.