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Posteromedial subtalar coalition: imaging appearances in three cases
1Department of Radiology, Nuffield Orthopaedic Centre, Oxford, UK.
Skeletal Radiology
|February 1, 2000
Summary
Posteromedial subtalar coalition, a rare hindfoot abnormality, can cause pain and stiffness. Imaging shows a characteristic pseudarthrosis posterior to the middle facet, often subtle on plain radiographs.
Area of Science:
- Orthopedics
- Radiology
- Anatomy
Background:
- Posteromedial subtalar coalition is a rare hindfoot malformation.
- It is distinct from middle facet coalition, with the sustentaculum uninvolved.
- This condition can present as hindfoot pain and stiffness.
Observation:
- Three cases of posteromedial subtalar coalition were identified.
- Patients presented with hindfoot pain.
- The coalition involved the posteromedial hindfoot.
Findings:
- Plain radiographs showed subtle posterior facet irregularity.
- MRI revealed a mixed bony and cartilaginous mass posterior to the sustentaculum.
- Associated findings included trabecular edema, narrowed facet space, posterior tibial vein prominence, and tibialis posterior tenosynovitis.
- CT identified the bony mass but missed adjacent edema.
Implications:
- Posteromedial subtalar coalition can be challenging to diagnose on plain radiographs.
- Characteristic imaging findings include a pseudarthrosis posterior to a normal middle facet.
- Accurate diagnosis relies on advanced imaging like MRI.