Tarsal Coalition in Pediatric Patients

A fibrous, cartilaginous, or bony (or a combination thereof) connection between two tarsal bones, or tarsal coalition usually involves the calcaneonavicular or talocalcaneal articulations. Foot pain, beginning when an initially fibrous coalition becomes partially or totally osseous and coinciding with trauma or increased stress such as athletic activity, is the usual presenting symptom. Although often identified on radiographs of the foot (including specialized projections), tarsal coalitions are increasingly imaged with computed tomography of the feet. Plain tomography, single contrast arthrography, and bone scintigraphy are no longer used in the evaluation of tarsal coalition. Magnetic resonance imaging has some advantages over computed tomography but its exact role remains undetermined. Surgical resection of symptomatic tarsal coalitions is used when conservative methods fail to alleviate symptoms.