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Tarsal Coalition in Pediatric Patients
Angela J. Gessner1, S. Jay Kumar, George W. Gross
1Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Seminars in Musculoskeletal Radiology
|June 2, 2001
Summary
Tarsal coalition, a connection between foot bones, causes pain when it ossifies. Imaging has advanced from X-rays to CT scans, with surgery as a last resort.
Area of Science:
- Orthopedics
- Podiatry
- Radiology
Background:
- Tarsal coalition involves abnormal fibrous, cartilaginous, or bony connections between tarsal bones.
- Most commonly affects calcaneonavicular and talocalcaneal joints.
- Pain typically arises when the coalition ossifies, often triggered by trauma or athletic stress.
Purpose of the Study:
- To review the presentation, diagnosis, and management of tarsal coalition.
- To highlight the evolution of diagnostic imaging techniques for tarsal coalition.
Main Methods:
- Review of current literature and diagnostic modalities for tarsal coalition.
- Comparison of imaging techniques including radiography, computed tomography (CT), and magnetic resonance imaging (MRI).
Main Results:
- Tarsal coalition diagnosis is shifting from plain radiography to CT scans.
- Plain tomography, arthrography, and bone scintigraphy are outdated for tarsal coalition evaluation.
- MRI shows promise but its definitive role compared to CT is still under investigation.
Conclusions:
- Tarsal coalition is a significant cause of foot pain, particularly in active individuals.
- Computed tomography is the current standard for diagnosing tarsal coalition.
- Surgical resection remains an option for refractory cases after conservative treatment failure.