American Board of Internal Medicine (ABIM) Certification Practice Exam

What common condition might contribute to the occurrence of tarsal tunnel syndrome?

1. Rheumatoid arthritis

2. Asthma

3. Psoriasis

4. Coronary artery disease

The correct answer is: Rheumatoid arthritis

Tarsal tunnel syndrome is a condition that occurs due to compression of the posterior tibial nerve as it travels through the tarsal tunnel, located behind the medial malleolus of the ankle. Rheumatoid arthritis is an autoimmune disorder that leads to inflammation and can affect various joints, including those in the ankle and foot. Inflammation from rheumatoid arthritis can result in swelling and structural changes, putting pressure on the surrounding nerves, including the posterior tibial nerve, thereby contributing to the development of tarsal tunnel syndrome. Other conditions listed, such as asthma, psoriasis, and coronary artery disease, do not have a direct connection to the mechanical compression or structural changes in the ankle area that lead to this neurological syndrome. While systemic diseases can affect overall health, they do not typically create the localized anatomical conditions that lead to tarsal tunnel syndrome as rheumatoid arthritis does.