CASE 86

By: Dr. Aliya Sarhan Al Barwani.

HISTORY: 30 years old with ankle pain.

What are the findings?

What is your diagnosis?

What are the three types of this disease?

FINDINGS:

Ankle X-Ray lateral view: C sign is seen.

MRI, coronal PD/FS:  There is complete fusion of the medial facet of the talus and sustentaculum tali with bone marrow continuity: Solid osseous fusion of the subtalar joint.

DIAGNOSIS:

Talocalcaneal coalition.

Three Types Are: Bony coalition, cartilaginous coalition and fibrous coalition.

PEARLS AND DISCUSSION:

Tarsal Coalition is fusion of two or more tarsal bones, maybe congenital or acquired. Patient usually presents in early adulthood or 2nd decades of life with ankle pain, sprain and stiffness. Most common coalition are Talocalcaneal (45%) and Calcaneonavicular (45%).

Three types of Coalition:

Bony, complete.

Cartilaginous, incomplete.

Fibrous, incomplete.

Calcaneonavicular coalition typically present between 8-12 years. Plain Radiograph shows elongation of the anterior process of the calcaneus (Anteater), MRI demonstrates bridging between the anterior process of the calcaneus and lateral aspect of the navicular.

FURTHER READING:

1.      David A. Lawrence, MD, Michael F. Rolen. Tarsal Coalitions: Radiographic, CT, and MR Imaging Findings. HSS J. (2014)

2.      Julia R. Crim1 and Kristina M. Kjeldsberg. Radiographic Diagnosis of Tarsal Coalition. AJR (2004)

3.      Newman JS1, Newberg AH. Congenital tarsal coalition: multimodality evaluation with emphasis on CT and MR imaging. Radiographics. (2000)