Ces radiol. 2012, 66(4):386-393

Tarsal coalitionOriginal article

Jindra Brtková¹, Petra Jiříčková²

¹ Radiologická klinika LF UK a FN, Hradec Králové

² Multiscan Radiologické centrum Pardubice

Aim: To summarize and display the imaging findings in patients with different types of both frequent and less frequent types of tarsal coalition, to discuss the imaging protocols, differential diagnoses and give brief information on clinical findings and treatment.

Method: The authors display CT, MRI and X-ray findings in 8 patients with the main types of coalition (talocalcaneal, calcaneonavicular), with a bilateral talocalcaneal coalition and in a patient with a complex synostosis.

Results: The encountered findings were: narrowed or absent joint space, thinned irregular cortical line, adjacent oedema and sclerosis and an unusual shape of the involved bones. Secondary degenerative changes in the adjacent joints were often encountered.
Depending on the type of coalition and on the projection, this diagnosis presents with X-ray findings, which are either prominent (in calcaneonavicular coalition and an oblique X-ray) or subtle and indirect (all other cases). In MRI and CT the diagnosis is much more obvious. The pathognomonic signs as well as secondary degenerative signs will be pointed out together with the appropriate imaging protocols. A differential diagnosis will be discussed.
The findings of the authors will be correlated with the literature.

Conclusion: It is necessary to be aware of the findings in tarsal coalition, in order to establish the diagnosis even in cases unsuspected by the clinitian. This is more challenging in plain X-rays, in CT and MRI it is mandatory to include the subtalar and tarsal joints in the examination of the ankle.

Keywords: CT, MRI, X-ray, tarsal coalition

Accepted: April 1, 2012; Published: December 1, 2012  Show citation