muscle atrophy with forefoot turned in and contracted up

[mars38]

Hi, I started having a burning pain in my left hip that traveled to almost my knee,it got worse the more I walked on it,had x-rays of hip it was normal,started physical therapy and soon it hurt to sit I then had a MRI of lumbar to check for sciatia MRI normal was told it had to be my psoriatic arthritis,I went to a chiropractor several times then decided to see my rheumatologist who gave some kind of cortisone injections along tailbone and in my hip my hip got a little better from this but thats when my family phyician noticed my left foot was spastic.It turned inward and when he pulled it over it snapped right back where it was at this point I could no longer raise my foot or toes I was sent to neurolgist who did and EMG with nerve conduction study it only showed slight neuropathy of left leg. I have hyperreflexia in all areas and he did a finger flick test on both hands that made my thumbs move slightly. I was told to take muscle relaxors and return in 6 weeks. By this time I had a very difficult time walking because my foot that was already bad was contractin inward and up and had burning pain. I have some weird things going on like when I rub the bottom of one foot the good foot or wipe my vaginal area it makes my left foot tingle. The doctor explained that by saying that it is a sensitive area in the vagina with a lot of nerves,it never happened before. I am now back in therapy for my foot and it is starting to relax it back to normal but I also need to build my muscles back up I have atrophy in left leg and weakness in right , any guesses?

[CCF-Neuro-M.D.-SH]

First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
    The symptoms and history you describe is not specific any any single disease, but is concerning for number of different possible disease processes.  
    The finger flick test with thumb movement is called Hoffman's sign and indicates hyperreflexia in the area of the cervical spine.  The symptoms that you describe of hyperreflexia, pain, numbness, weakness and atrophy are consistent with a spinal process.  Given your initial negative MRI of the lumbar spine, I would recommend an MRI of your Cervical spine.  Disc disease, inflammatory disorders, tumors etc, in the cervical region and affect the areas of the leg and cause the symptoms you describe.  Another possibility would be an upper motor neuron (in the brain) process (causes spasticity).  To evaluate for this you should have an MRI of your brain.  You should also make sure your MRIs are done with contrast.  Finally, you should have a lumbar puncture to look for inflammation(such as multiple sclerosis), lyme and cancer in the spinal fluid.
I hope this has been helpful.

[vega1318]

Sounds like you need to have imaging done of your brain as well as your cervical / thoracic spine to make sure there's nothing going on there.  Spastic changes usually take place higher than where "sciatica" does, and that means anywhere from your thoracic spine and up, including your brain.  You seem to be normal, otherwise, but there may be a small problem somewhere along the course that's irritating your "foot nerves" tract.

Go to a movement disorders specialist (special neurologist)

[mars38]

I didn't tell you maybe the most important thing, I just finished a year of enbrel, and I am scheduled for a brain and cervical MRI this week.