Tarsal coalition

Abstract

Tarsal coalition is a common abnormality of the hindfoot skeleton that only rarely leads to symptoms. These symptoms occur most commonly in adolescence but rarely can be found also in adults. Although most coalitions are congenital, as the consequence of autosomal dominant inheritance, coalitions also can be acquired by degenerative joint disease, inflammatory arthritis, infection, and clubfoot deformities. Fifty percent of all coalitions are bilateral. Talocalcaneal and calcaneonavicular coalitions are most commonly found, and patients frequently have more than one coalition in the same foot. Clinical symptoms of the tarsal coalition frequently follow a sequence of sprains or other minor injuries to the involved foot. This leads to a rigid, painful foot. The pain is worsened by continued activities. The frequently cited peroneal spastic flatfoot is an uncommon means of identifying a tarsal coalition. The diagnosis of the tarsal coalition is made on the oblique radiograph of the foot, which demonstrates the calcaneonavicular coalition. Computed tomography (CT) and magnetic resonance imaging scans show the presence and extent of other coalitions. Secondary signs for the presence of a coalition are talar beaking, anteater nose sign, and C sign. These secondary signs can be demonstrated best on a lateral view of the involved foot. Local anesthetic blocks under image intensifier or CT guidance can identify areas of joint degeneration, which are caused by the altered biomechanics of the foot. Initial treatment should consist of conservative therapy in the form of support or immobilization of the involved foot, change in the activities of the patient, and nonsteroidal anti-inflammatory medication. Surgical treatment in the form of a resection of the coalition should be reserved for those patients for whom conservative therapy has failed. Subtalar or triple arthrodesis should be reserved for those patients for whom all other therapy has failed.

Diagnostic value of radiological signs..86 of tarsal coalitions

“…К прямым рент-генологическим признакам относят наличие отчетливой зоны патологического сращения костей предплюсны на рентгенограмме [3,6]. Однако в большинстве случаев судить о нали-чии тарзальной коалиции приходится по кос-венным рентгенологическим признакам.…”

“…К косвенным рентгенологическим призна-кам тарзальных коалиций относят ряд рентгено-логических симптомов, позволяющих заподо-зрить наличие сращения [3,6]. Они могут либо непосредственно указывать на конкресценцию (симптом «носа муравьеда»), либо показывать вторичные изменения, связанные с данным па-тологическим состоянием (симптом «клюва», С-симптом).…”

“…По данным большин-ства авторов, частота встречаемости тарзальных коалиций составляет 1-2% [1,3,5,6]. Однако в связи с широким развитием методов лучевой ви- Тарзальная коалиция -это аномальное сращение двух и более костей предплюсны, которое может приводить к де-формациям стопы, болевому синдрому и повреждениям связок голеностопного сустава.…”

Bilateral Tarsal Coalition in a National Collegiate Athletic Association Division I Basketball Player: A Case Report

“…1,2 Although tarsal coalition has been primarily reported as a congenital condition due to an inherited autosomal dominant disorder, the coalition has also been acquired as a result of degenerative joint disease or arthritis. [2][3][4] The prevalence of tarsal coalition has been estimated from less than 1% to 13% of the population, with 50% of the cases occurring bilaterally. [1][2][3][5][6][7][8][9] The 2 most common locations of tarsal coalition are the talocalcaneal and calcaneonavicular joints.…”

“…[2][3][4] The prevalence of tarsal coalition has been estimated from less than 1% to 13% of the population, with 50% of the cases occurring bilaterally. [1][2][3][5][6][7][8][9] The 2 most common locations of tarsal coalition are the talocalcaneal and calcaneonavicular joints. 1,4,5,8,9 Tarsal coalitions are described based on the progressive morphology of the coalition, from fibrous (syndesmosis) to cartilaginous (synchondrosis) and finally to osseous (synostosis).…”