RESUMEN
Tarsal coalition is an abnormal bony, cartilaginous, or fibrous bridge between 2 or more tarsal bones. Adolescent athletes with tarsal coalitions typically present with symptoms that include foot and/or ankle pain and limited range of motion. Loss of mobility can lead to abnormal loading, articular instability, deformity, and joint degeneration. Nonoperative management includes immobilization, physical therapy, and custom foot orthosis. Surgical options include coalition excision and fat graft interposition, foot realignment, or a combination of these. Surgical treatment requires evaluation of the coalition type, foot alignment, and degenerative changes in the adjacent joints.
RESUMEN
BACKGROUND: Fibrocartilaginous coalition of the third tarsometatarsal joint has been indicated as an extremely rare form of tarsal coalition in the radiological literature, and most articles concerned with tarsal coalition do not mention involvement of this joint. Only two reports written in the English language that approach this subject were found, an orthopedic report and an anthropological report. PURPOSE: To evaluate the prevalence of this finding and discuss and illustrate the radiological characteristics of this coalition. MATERIAL AND METHODS: A retrospective analysis of 614 computed tomography or magnetic resonance imaging scans of the ankle and/or foot, acquired at a health service within a period of three months, was performed to assess the prevalence of this coalition. RESULTS: Of the examinations characterized as valid for analysis for the purposes of the study, 17 cases compatible with fibrocartilaginous coalition of the third tarsometatarsal joint were found, thus indicating an involvement of approximately 2.97% of the examined feet. CONCLUSION: Our radiological findings are typical, and the prevalence found in this study was statistically significant, being similar to that described in the anthropological report (3.2%-6.8%).
Asunto(s)
Displasia Fibrosa Ósea/diagnóstico por imagen , Displasia Fibrosa Ósea/epidemiología , Imagen por Resonancia Magnética/métodos , Coalición Tarsiana/diagnóstico por imagen , Coalición Tarsiana/epidemiología , Tomografía Computarizada por Rayos X/métodos , Adolescente , Adulto , Estudios Transversales , Femenino , Articulaciones del Pie/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Huesos Tarsianos/diagnóstico por imagen , Adulto JovenRESUMEN
Abstract: The talonavicular coalition is a rare congenital anomaly of the foot, often associated with other malformations. Unlike other coalitions, most patients are asymptomatic and do not require surgery. The authors describe two cases of patients with talonavicular coalition, one bilateral and the other unilateral associated with other malformations. The sign of the mushroom is presented as a practical way to diagnose talonavicular coalition on a standing anteroposterior radiograph, in which the contours of the bone fusion mimic the shape of a mushroom. This sign will help radiologists in the proper diagnosis of this rare coalition.
Resumen: La coalición talonavicular es una anomalía congénita poco frecuente del pie, a menudo asociada a otras malformaciones. A diferencia de otras coaliciones, la mayoría de los pacientes son asintomáticos, y no requieren cirugía. Los autores describen 2 casos de pacientes con coalición talonavicular, uno bilateral y el otro unilateral, asociados a otras malformaciones. Presentamos el signo de la seta como una práctica manera de diagnosticar la coalición talonavicular en proyección anteroposterior del pie, en el cual los contornos de la fusión ósea remedan la forma de un hongo. Este signo será de ayuda a los radiólogos para el adecuado diagnóstico de esta rara coalición.
Asunto(s)
Humanos , Huesos del Pie/anomalías , Astrágalo/anomalías , Coalición Tarsiana/diagnóstico por imagenRESUMEN
The tarsal coalition corresponds to the abnormal osseous, cartilaginous or fibrous joining between two or more bones in the midfoot or hindfoot. The anteater nose sign is caused by a tubular elongation of the anterior process of the calcaneus that approaches or overlaps the tarsal scaphoid (navicular) and resembles the nose of an anteater on a lateral foot or ankle radiograph.
La coalición tarsal corresponde a la unión anormal, ya sea ósea, cartilaginosa o fibrosa, entre dos o más huesos del retro o medio pie. El signo de la nariz del oso hormiguero es causada por un alargamiento tubular del proceso anterior del calcáneo que se acerca o se superpone con el escafoides tarsiano y se asemeja a la nariz de un oso hormiguero en una radiografía lateral del pie o tobillo.