Congenital Tarsal Coalition: Multimodality Evaluation with Emphasis on CT and MR Imaging1
(CME available in print version and on RSNA Link)
Joel S. Newman, MD and
Arthur H. Newberg, MD
1 From the Department of Radiology, New England Baptist Bone and Joint Institute, New England Baptist Hospital, 125 Parker Hill Ave, Boston, MA 02120. Presented as a scientific exhibit at the 1998 RSNA scientific assembly. Received March 1, 1999; revisions requested April 26 and received June 11; accepted June 14. Address reprint requests to J.S.N. (e-mail: jnewman@nebh.org).
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Figure 1a. Calcaneonavicular coalition in an 11-year-old boy. (a) Oblique radiographs of both feet reveal a nonosseous coalition on the left (arrow). (b) Lateral radiograph of the left foot shows enlargement of the anterior dorsal calcaneus (arrows), referred to as the "anteater sign."
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Figure 1b. Calcaneonavicular coalition in an 11-year-old boy. (a) Oblique radiographs of both feet reveal a nonosseous coalition on the left (arrow). (b) Lateral radiograph of the left foot shows enlargement of the anterior dorsal calcaneus (arrows), referred to as the "anteater sign."
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Figure 2. Talonavicular and calcaneocuboid coalitions in a 7-year-old boy. Oblique radiographs of both feet demonstrate bilateral talonavicular (arrows) and calcaneocuboid (arrowheads) coalitions.
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Figure 3. Talar beak in a 34-year-old man with a talocalcaneal coalition. Lateral radiograph of the right foot shows a talar beak (arrow).
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Figure 4. Complete C sign in a 30-year-old man with a talocalcaneal coalition. Lateral radiograph of the left foot shows a complete C sign (arrowheads).
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Figure 5a. Calcaneonavicular coalition in an 11-year-old boy. Axial (a) and coronal (b) CT scans show apposition of the anterior dorsal calcaneus with the navicular in the left foot, with narrowing and reactive sclerosis (arrow).
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Figure 5b. Calcaneonavicular coalition in an 11-year-old boy. Axial (a) and coronal (b) CT scans show apposition of the anterior dorsal calcaneus with the navicular in the left foot, with narrowing and reactive sclerosis (arrow).
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Figure 6a. Calcaneonavicular coalition in a 22-year-old man. Axial (a) and coronal (b) CT scans demonstrate a calcaneonavicular coalition (arrows) in the left foot.
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Figure 6b. Calcaneonavicular coalition in a 22-year-old man. Axial (a) and coronal (b) CT scans demonstrate a calcaneonavicular coalition (arrows) in the left foot.
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Figure 7. Calcaneonavicular coalitions in a 39-year-old man. Axial CT scan demonstrates bilateral calcaneonavicular coalitions (arrows) and secondary degenerative changes.
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Figure 8a. Cubonavicular coalition in a 10-year-old girl. (a) Oblique radiograph of the right foot shows abnormal narrowing of the space between the cuboid and navicular (arrow) and apparent narrowing of the calcaneonavicular space. (b) Coronal CT scan helps confirm a cubonavicular coalition (arrow). No calcaneonavicular coalition was identified.
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Figure 8b. Cubonavicular coalition in a 10-year-old girl. (a) Oblique radiograph of the right foot shows abnormal narrowing of the space between the cuboid and navicular (arrow) and apparent narrowing of the calcaneonavicular space. (b) Coronal CT scan helps confirm a cubonavicular coalition (arrow). No calcaneonavicular coalition was identified.
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Figure 9a. (9) Talocalcaneal coalitions in a 25-year-old woman. (a) Lateral radiograph of the left foot shows narrowing of the posterior subtalar joint (arrow). (b, c) Coronal CT scans show bilateral osseous coalitions (arrows) involving the middle facets (b) and posterior facets (c).
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Figure 9b. (9) Talocalcaneal coalitions in a 25-year-old woman. (a) Lateral radiograph of the left foot shows narrowing of the posterior subtalar joint (arrow). (b, c) Coronal CT scans show bilateral osseous coalitions (arrows) involving the middle facets (b) and posterior facets (c).
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Figure 9c. (9) Talocalcaneal coalitions in a 25-year-old woman. (a) Lateral radiograph of the left foot shows narrowing of the posterior subtalar joint (arrow). (b, c) Coronal CT scans show bilateral osseous coalitions (arrows) involving the middle facets (b) and posterior facets (c).
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Figure 10. Bilateral, nonosseous talocalcaneal coalitions in a 19-year-old man. Coronal CT scan demonstrates abnormal downward sloping of both sustentacula tali (arrows).
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Figure 11a. Calcaneonavicular coalition in a 47-year-old woman. (a) Oblique radiograph of the left foot shows abnormal apposition of the calcaneus and navicular (arrows). (b) Sagittal T1-weighted MR image shows the anteater sign (arrows). (c) Sagittal T2-weighted MR image reveals the nonosseous coalition (arrow). Marked narrowing between the calcaneus and navicular with reactive "cystic" changes in the underlying bone are seen on both MR images.
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Figure 11b. Calcaneonavicular coalition in a 47-year-old woman. (a) Oblique radiograph of the left foot shows abnormal apposition of the calcaneus and navicular (arrows). (b) Sagittal T1-weighted MR image shows the anteater sign (arrows). (c) Sagittal T2-weighted MR image reveals the nonosseous coalition (arrow). Marked narrowing between the calcaneus and navicular with reactive "cystic" changes in the underlying bone are seen on both MR images.
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Figure 11c. Calcaneonavicular coalition in a 47-year-old woman. (a) Oblique radiograph of the left foot shows abnormal apposition of the calcaneus and navicular (arrows). (b) Sagittal T1-weighted MR image shows the anteater sign (arrows). (c) Sagittal T2-weighted MR image reveals the nonosseous coalition (arrow). Marked narrowing between the calcaneus and navicular with reactive "cystic" changes in the underlying bone are seen on both MR images.
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Figure 12. Calcaneonavicular coalition with associated edema in an 11-year-old boy. Sagittal STIR image reveals marked bone marrow edema (arrow).
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Figure 13a. Talocalcaneal coalition in a 39-year-old woman. (a) Coronal proton density-weighted image shows an abnormal middle facet (arrows). (b) On a STIR image, bone marrow edema is evident about the posterior subtalar joint (arrows).
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Figure 13b. Talocalcaneal coalition in a 39-year-old woman. (a) Coronal proton density-weighted image shows an abnormal middle facet (arrows). (b) On a STIR image, bone marrow edema is evident about the posterior subtalar joint (arrows).
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Figure 14a. Talocalcaneal coalition in a 20-year-old man. (a) Sagittal T1-weighted scan shows a talar beak (arrow). (b) Coronal proton density-weighted image reveals a middle facet coalition (arrow). Note the abnormal broadening and downsloping of the sustentaculum. (c) Coronal STIR image shows the associated bone marrow edema (arrows).
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Figure 14b. Talocalcaneal coalition in a 20-year-old man. (a) Sagittal T1-weighted scan shows a talar beak (arrow). (b) Coronal proton density-weighted image reveals a middle facet coalition (arrow). Note the abnormal broadening and downsloping of the sustentaculum. (c) Coronal STIR image shows the associated bone marrow edema (arrows).
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Figure 14c. Talocalcaneal coalition in a 20-year-old man. (a) Sagittal T1-weighted scan shows a talar beak (arrow). (b) Coronal proton density-weighted image reveals a middle facet coalition (arrow). Note the abnormal broadening and downsloping of the sustentaculum. (c) Coronal STIR image shows the associated bone marrow edema (arrows).
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Figure 15a. Osseous talocalcaneal coalition in a 39-year-old woman. Coronal proton density-weighted (a) and sagittal T1-weighted (b) images show bone marrow contiguity across fused articulation (arrow).
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Figure 15b. Osseous talocalcaneal coalition in a 39-year-old woman. Coronal proton density-weighted (a) and sagittal T1-weighted (b) images show bone marrow contiguity across fused articulation (arrow).
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Figure 16a. Multimodality imaging of osseous talocalcaneal coalition in a 25-year-old woman. (a) On a lateral radiograph, the right foot appears relatively normal. (b) On a bone scan, there is increased uptake of radiotracer (arrow) along the right subtalar joint. (c) Coronal CT scan reveals a middle facet coalition (arrow). (d) Coronal proton density-weighted MR image shows bone marrow contiguity (arrow) across the bridged middle facet.
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Figure 16b. Multimodality imaging of osseous talocalcaneal coalition in a 25-year-old woman. (a) On a lateral radiograph, the right foot appears relatively normal. (b) On a bone scan, there is increased uptake of radiotracer (arrow) along the right subtalar joint. (c) Coronal CT scan reveals a middle facet coalition (arrow). (d) Coronal proton density-weighted MR image shows bone marrow contiguity (arrow) across the bridged middle facet.
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Figure 16c. Multimodality imaging of osseous talocalcaneal coalition in a 25-year-old woman. (a) On a lateral radiograph, the right foot appears relatively normal. (b) On a bone scan, there is increased uptake of radiotracer (arrow) along the right subtalar joint. (c) Coronal CT scan reveals a middle facet coalition (arrow). (d) Coronal proton density-weighted MR image shows bone marrow contiguity (arrow) across the bridged middle facet.
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Figure 16d. Multimodality imaging of osseous talocalcaneal coalition in a 25-year-old woman. (a) On a lateral radiograph, the right foot appears relatively normal. (b) On a bone scan, there is increased uptake of radiotracer (arrow) along the right subtalar joint. (c) Coronal CT scan reveals a middle facet coalition (arrow). (d) Coronal proton density-weighted MR image shows bone marrow contiguity (arrow) across the bridged middle facet.
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Copyright © 2000 by the Radiological Society of North America.
