Tarsal Coalitions

A retrospective MRI analysis of bone and soft tissue changes associated with the spectrum of tarsal coalitions

DOI: 10.1002/ca.23866

Figure Legends: 

Figure 1: Anteroposterior direct radiograph of the ankle (a) shows talocalcaneal non-osseous coalition and os sustentaculum (arrow). Posterior tibial nerve (arrowheads) is compressed at coalition level (arrow) on sagittal plane T1-weighted image (b). Sagittal STIR image (c) shows cystic and edema-like changes (arrow) adjacent to the coalition.

Figure 2. Non-osseous calcaneonavicular coalition is seen on STIR (a) and T1-weighted (b) images. On the STIR image (a), intense bone marrow edema (arrows) accompanying the coalition is noted.

Abstract: 

Purpose: It was aimed to investigate the bone and soft tissue changes accompanying tarsal coalition and aimed to evaluate their association with the location and type of coalition.

Materials and Methods:

Ankle MRIs of 65 patients with tarsal coalition were included. The relationship between the location and type of coalition and bone marrow edema, subchondral cysts, sinus tarsi syndrome, tarsal tunnel syndrome, posterior impingement syndrome, accessory bone, tibiotalar effusion, talar osteochondritis dissecans, ganglion cysts, and calcaneal spur were evaluated. Twenty-nine patients without coalition were selected as the control group, and the distribution of these variables between the two groups was analyzed.

Results:

There were 33 females and 32 males in the coalition group (mean age: 42.0 ± 15.63 years), and 22 females and seven males in the control group (mean age: 44.79 ± 12.33 years). Coalition was most common in the talocalcaneal joint (n = 33, 50.8%), and the most common coalition type was non-osseous (n = 57, 87.6%). We find no significant difference between the pathologies defined in terms of coalition location and type. Sinus tarsi syndrome, tarsal tunnel syndrome, subchondral cysts, and tibiotalar effusion were found to be more common in the coalition group (p = 0.028, p = 0.010, p = 0.023, and p = 0.006, respectively). The presence of coalition increased the probability of developing tarsal tunnel syndrome 9.91 times (95% CI: [1.25-78.59]; p = 0.029), and sinus tarsi syndrome 3.66 times (95% CI: [1.14-11.78]; p = 0.029).

Conclusion:

Tarsal coalition may predispose bone and soft tissue changes. In this study, sinus tarsi syndrome, tarsal tunnel syndrome, subchondral cysts and tibiotalar effusion were found to be more common in the coalition group.

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