Rigid Painful Flatfoot Secondary to Tarsal Coalition

Cowell, Henry; Elener, Valerie

doi:10.1097/00003086-198307000-00009

Cited by 124 publications

(57 citation statements)

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“…1). Tarsal coalition, an abnormal union of two or more tarsal bones (Cowell and Elener 1983;Carson et al 1991), may be either congenital or acquired, and has a reported prevalence of about 1% in the general population. The true frequency is probably higher, however, as many coalitions are asymptomatic (Sartoris and Resnick 1985).…”

Section: Discussionmentioning

confidence: 99%

The ‘Small-Patella’ Syndrome

Dellestable¹,

Péré²,

Blum

et al. 1996

The Journal of Bone and Joint Surgery. British volume

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We describe a syndrome combining abnormalities of the pelvis, knee and foot in three related patients with a familial history of small dislocated patellae. The clinical and radiological appearance of the patella and pelvis is consistent with the 'small-patella' syndrome, a rare autosomal dominant disorder. There were also previously unreported deformities affecting the feet. The 'small-patella' syndrome, first described by Scott and Taor in 1979, is characterised by patellar aplasia or hypoplasia and abnormalities of the pelvic girdle. We describe a family in which the classic anomalies of this syndrome are associated with minor morphological variations of the hindfoot. We present the radiological features and discuss the aetiology. CASE REPORTSCase 1 (III3, Fig. 1). A 68-year-old woman was admitted with bilateral chronic knee and ankle pain. She was obese and had a personal and family history of recurrent dislocation of small patellae (Fig. 1).Physical examination revealed small, laterally placed patellae, flat feet, and limited subtalar motion. The other peripheral joints were normal and there was no nail dystrophy or leg shortening. Radiographs (Fig. 2) showed multiple skeletal abnormalities, including small dislocated patellae, bilateral defective formation of the ischiopubic junction, hypoplasia of the lesser trochanters, infra-acetabular notches, ball-and-socket ankle joints, secondary radiological signs of bilateral talocalcaneal coalition with narrowing of the posterior talocalcaneal joint space and a talar beak, hypertrophy of the neck of the talus and broadbased plantar calcaneal exostoses.Three-dimensional CT of the pelvis showed thin ischiopubic junctions and emphasised the infra-acetabular notches (Fig. 3a). Coronal CT of the right hindfoot (Fig. 3b) identified talocalcaneal coalition at the level of the sustentaculum tali. No other skeletal abnormalities were seen. Case 2 (IV1, Fig. 1). This 49-year-old woman, the daughter of the patient in case 1, had small patellae. Radiographs of the pelvis, knees and hindfeet showed small patellae, hypoplasia of the ischiopubic junction, hypertrophy of the neck Fig. 1 Genealogical table of the family reported.

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Section: Discussionmentioning

confidence: 99%

The ‘Small-Patella’ Syndrome

Dellestable¹,

Péré²,

Blum

et al. 1996

The Journal of Bone and Joint Surgery. British volume

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“…This delayed presentation of a congenital problem has been attributed to the conversion of fibrous or cartilaginous union to osseous fusion, the former being rarely symptomatic (2,3). Typically, vague foot pain exaggerated by vigorous use or prolonged standing is noted, often beginning after minor trauma or unusual activity (1,17).…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…Talocalcaneal coalition is seen more frequently in males and occurs bilaterally in up to 25% of patients (3,17). Ossification occurs between the ages of 12 and 16 (2). Osseous coalitions may be overlooked on standard frontal and lateral radiographs, or even simulated in normal feet (3,19).…”

Section: Radiographic Classificationmentioning

confidence: 99%

“…Conventional radiographs, particularly the lateral view, are usually adequate for the diagnosis of this uncommon variety of tarsal fusion (Figure 7) (1,3). Osseous bridging occurs between the ages of 3 and 5 years, and may be asymptomatic or associated with peroneal spasm (1,2). Abnormalities of the fifth digit of the hand may occur concomitantly, and both autosomal dominant and recessive inheritance patterns have been observed (10,23).…”

Section: Radiographic Classificationmentioning

confidence: 99%

“…TARSAL COALITION DAVID J. SARTORIS and DONALD L. RESNICK Tarsal coalition, or fusion, refers to the union of 2 or more tarsal bones into a single structure, with consequent absence of normal relative motion between them (1,2). The connection may be fibrous (syndesmosis), cartilaginous (synchondrosis), or osseous (synostosis) (1,3).…”

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confidence: 99%

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Tarsal Coalition

Sartoris

Resnick

1985

Arthritis & Rheumatism

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Skeletal Kinship Analysis Using Developmental Anomalies of the Foot

Case

Jones

Offenbecker

2016

Int. J. Osteoarchaeol.

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Developmental anomalies of the skeleton are often treated as mere curiosities, but in some contexts, they may prove useful to bioarchaeologists for answering questions about the past. One such use can be found in skeletal kinship analysis, where discrete traits can help to identify close genetic relatives in archaeological cemeteries. Previous research suggests that discrete traits used for skeletal kinship analysis should have several characteristics-they must obviously be heritable, but in addition, they should be easy to score as present or absent, their frequencies should not vary by age or sex, and they should be low frequency traits. Low frequency traits are less likely than higher frequency traits to be found in two individuals merely by chance. In this study, we consider 17 developmental anomalies of the human foot as candidates for use in skeletal kinship analysis. The traits are evaluated in terms of the characteristics described above, after which kinship analyses are attempted on two different populations. Ten of the anomalies are found to be good candidates for skeletal kinship analysis, including accessory navicular, four different forms of brachydactyly, three types of tarsal coalition, and two forms of the os intermetatarseum. When frequencies of these traits were examined and compared to a reference sample in three cemeteries, however, only a single group of six possible genetic relatives were identified. The results suggest that skeletal kinship analysis using individual heritable traits is perhaps best applied to small cemeteries or burial clusters rather than larger cemeteries containing many different lineages.

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Rigid Painful Flatfoot Secondary to Tarsal Coalition

Cited by 124 publications

References 0 publications

The ‘Small-Patella’ Syndrome

The ‘Small-Patella’ Syndrome

Tarsal Coalition

Skeletal Kinship Analysis Using Developmental Anomalies of the Foot

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