Tarsal Coalitions: Radiographic, CT, and MR Imaging Findings
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Tarsal coalitions affect up to 13% of the population and can be a cause of chronic ankle and hindfoot pain. They can be subdivided as osseous, cartilaginous, or fibrous types, each with unique radiographic, CT, and MR imaging findings. In particular, MR imaging offers the unique ability to determine the exact type of tarsal coalition that is present as well as whether any associated soft tissue abnormalities are present.
The purposes of this paper were to (1) review the anatomy of the hindfoot; (2) review the radiographic, CT, and MR imaging findings of tarsal coalitions; and (3) review the imaging appearance of the specific types of tarsal coalitions.
Online searches were performed using Google Scholar with the search criteria of “tarsal coalition,” “hindfoot anatomy,” and “subtalar coalition,” and limiting the searches to papers published in the last 10 years in major radiology journals.
The anatomy of the hindfoot is complex but essential to understand. There are various radiographic, CT, and MR imaging findings that can be consistently noted in cases of tarsal coalition. The specific types of tarsal coalition demonstrate characteristic imaging findings.
Knowledge of the normal anatomy of the foot, in particular the hindfoot, combined with the knowledge of the imaging characteristics of different histologic subtypes of coalitions (osseous, cartilaginous, and fibrous) is essential for interpreting radiographic, CT, and MR images of the ankle and foot.
- Bohne, WH (2001) Tarsal coalition. Current Opinion in Pediatrics 13: pp. 29-35 CrossRef
- Brown, RR, Rosenberg, ZS, Thornhill, BA (2001) The C sign: more specific for flatfoot deformity than subtalar coalition. Skeletal Radiology 30: pp. 84-87 CrossRef
- Conway, JJ, Cowell, HR (1969) Tarsal coalition: clinical significance and roentgenographic demonstration. Radiology 92: pp. 799-811
- Crim, J (2008) Imaging of tarsal coalition. Radiologic Clinics of North America 46: pp. 1017-1026 CrossRef
- Crim, JR, Kjeldsberg, KM (2004) Radiographic diagnosis of tarsal coalition. AJR American journal of roentgenology 182: pp. 323-328 CrossRef
- Donovan, A, Rosenberg, ZS (2010) MRI of ankle and lateral hindfoot impingement syndromes. AJR American journal of roentgenology 195: pp. 595-604 CrossRef
- Downey, MS (1991) Tarsal coalitions. A surgical classification. Journal of the American Podiatric Medical Association 81: pp. 187-197 CrossRef
- Gardner, E, Gray, DJ, O’Rahilly, R (1959) The prenatal development of the skeleton and joints of the human foot. The Journal of Bone and Joint Surgery American Volume 41-A: pp. 847-876
- Harris, BJ (1955) Anomalous structures in the developing human foot. Anat Rec 121: pp. 399
- Harris, RI (1955) Rigid valgus foot due to talocalcaneal bridge. The Journal of Bone and Joint Surgery American Volume 37-A: pp. 169-183
- Harris, RI, Beath, T (1948) Etiology of peroneal spastic flat foot. The Journal of Bone and Joint Surgery British Volume 30B: pp. 624-634
- Leonard, MA (1974) The inheritance of tarsal coalition and its relationship to spastic flat foot. The Journal of Bone and Joint Surgery British Volume 56B: pp. 520-526
- Linklater, J, Hayter, CL, Vu, D, Tse, K (2009) Anatomy of the subtalar joint and imaging of talo-calcaneal coalition. Skeletal Radiology 38: pp. 437-449 CrossRef
- Liu, PT, Roberts, CC, Chivers, FS (2003) “Absent middle facet”: a sign on unenhanced radiography of subtalar joint coalition. AJR American Journal of Roentgenology 181: pp. 1565-1572 CrossRef
- Manaster BJ. Diagnostic imaging. Musculoskeletal: non-traumatic disease. Salt Lake City: Amirsys, 2010.
- Mosier, KM, Asher, M (1984) Tarsal coalitions and peroneal spastic flat foot. A review. The Journal of Bone and Joint Surgery American Volume 66: pp. 976-984
- Nalaboff, KM, Schweitzer, ME (2008) MRI of tarsal coalition: frequency, distribution, and innovative signs. Bulletin of the NYU Hospital for Joint Diseases 66: pp. 14-21
- Newman JS, Newberg AH. Congenital tarsal coalition: multimodality evaluation with emphasis on CT and MR imaging. Radiographics: A Review Publication of the Radiological Society of North America, Inc. 2000; 20:321–332; quiz 526–327, 532.
- Pastore, D, Cerri, GG, Haghighi, P, Trudell, DJ, Resnick, DL (2009) Ligaments of the posterior and lateral talar processes: MRI and MR arthrography of the ankle and posterior subtalar joint with anatomic and histologic correlation. AJR American Journal of Roentgenology 192: pp. 967-973 CrossRef
- Perlman, MD, Wertheimer, SJ (1986) Tarsal coalitions. The Journal of Foot Surgery 25: pp. 58-67
- Resnick, D (1984) Talar ridges, osteophytes, and beaks: a radiologic commentary. Radiology 151: pp. 329-332
- Rios, AM, Rosenberg, ZS, Bencardino, JT, Rodrigo, SP, Theran, SG (2011) Bone marrow edema patterns in the ankle and hindfoot: distinguishing MRI features. AJR American Journal of Roentgenology 197: pp. W720-729 CrossRef
- Rosenberg ZS, Beltran J, Bencardino JT. From the RSNA Refresher Courses. Radiological Society of North America. MR imaging of the ankle and foot. Radiographics: a review publication of the Radiological Society of North America, Inc. 2000; 20 spec no:S153–179.
- Sijbrandij, ES, Gils, AP, Lange, EE, Sijbrandij, S (2002) Bone marrow ill-defined hyperintensities with tarsal coalition: MR imaging findings. European Journal of Radiology 43: pp. 61-65 CrossRef
- Slomann, H (1921) On coalition calcaneo-navicularis. J Orthop Surg 3: pp. 586-602
- Solomon, LB, Ruhli, FJ, Taylor, J, Ferris, L, Pope, R, Henneberg, M (2003) A dissection and computer tomograph study of tarsal coalitions in 100 cadaver feet. Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society 21: pp. 352-358 CrossRef
- Stormont DM, Peterson HA. The relative incidence of tarsal coalition. Clinical Orthopaedics and Related Research 1983;28–36.
- Talkhani, I, Laing, P (1999) Cuboid-navicular coalition in an adult: a case report. Foot and Ankle Surgery 5: pp. 151-154 CrossRef
- Tarsal Coalitions: Radiographic, CT, and MR Imaging Findings
HSS Journal ®
Volume 10, Issue 2 , pp 153-166
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- tarsal coalition
- subtalar coalition
- calcaneonavicular coalition
- Industry Sectors
- Author Affiliations
- 1. Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA
- 2. School of Medicine, American University of Beirut, Beirut, Lebanon
- 3. 1606 Leist Avenue, Lima, OH, 45805, USA