A dissection and computer tomograph study of tarsal coalitions in 100 cadaver feet

Abstract

Most of the clinical studies report the incidence of tarsal coalitions (TC) as less than 1% but they disregard the asymptomatic coalitions. TC have been associated with degenerative arthritic changes. After X-rays, computer tomography (CT) is the most commonly used diagnostic test in the detection of TC.The aims of our study were to establish the incidence of TC; the association between T C and accessory tarsal bones and between TC and tarsal arthritis; and to assess the sensitivity of CT as a diagnostic tool in TC. We performed spiral CT scans of 100 cadaver feet (mean age at death 77.7 & 10.4), which were subsequently dissected. The dissections identified nine non-osseous TC: two talocalcaneal and seven calcaneonavicular. There was no osseous coalition. Tarsal arthritis was identified in 3 1 cases. Both talocalcaneal coalitions were associated with arthritis while none of the calcaneonavicular coalitions were associated with tarsal arthritis. The CT diagnosed an osseous talocalcaneal coalition and was suspicious of fibrocartilaginous coalitions in eight cases. There was correlation between dissection and CT in two talocalcaneal coalitions and three calcaneonavicular coalitions thus CT identifying 55.50/0 of the coalitions. C T did not diagnose four non-osseous coalitions and diagnosed errouresly four possible coalitions. In conclusion our study demonstrated that the incidence of non-osseous T C is higher than previously thought ( 12.72'%). The calcaneonavicular coalitions are the most common single type (9.09%) and they d o not seem to be associated with arthritic changes in the tarsal bones. Our CT results suggest that spiral CT has a low sensitivity in the detection of non-osseous coalitions and questions if multislice CT should be used routinely when TC are suspected.Crown

Foot anomalies in the Late Neolithic/Chalcolithic population exhumed from the rock cut cave of São Paulo 2 (Almada, Portugal)

“…The real frequency of this non-osseous coalition is uncertain since the majority of the studies are of clinical samples, that is, studies that do not include the asymptomatic cases. Solomon et al (2003), found a much higher incidence of TC, 12.72% than in all previous reports. This study was performed in an embalmed cadaver sample of the Ray Last Laboratory (dissecting room) of the Department of Anatomical Sciences of the University of Adelaide.…”

Hamate‐pisiform coalition: Morphology, clinical significance, and a simplified classification scheme for carpal coalition

“…The sample frequency of 0.76% reported here is likely higher than found by Cockshott because of differences in diagnostic ability. Studies based on radiographs or other imaging techniques are more likely to miss coalition cases relative to skeletal analysis or dissection, as documented recently for tarsal coalitions (Solomon et al, 2003). In particular, non-osseous cases are most likely to be missed.…”

Diagnostic value of radiological signs..86 of tarsal coalitions

“…При стандартном рентгенологическом об-следовании редко удаётся визуализировать место сращения, что связано с преобладанием хрящевых и фиброзных форм коалиций [9,11]. Кроме того, сложность анатомии предплюсны обуславливает дополнительные трудности в визуализации данной патологии.…”