Tarsal tunnel disease and talocalcaneal coalition: MRI features

Alaia, Erin F.; Rosenberg, Zehava Sadka; Bencardino, Jenny T.; Ciavarra, Gina; Rossi, Ignacio; Petchprapa, Catherine

doi:10.1007/s00256-016-2461-0

Cited by 21 publications

(17 citation statements)

References 26 publications

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“…MRI can confirm the diagnosis and is the most valuable noninvasive auxiliary examination for the observation of tendon tissue lesions. 13 For the case with swelling and tenderness in the extending direction of FHLT, especially the case with recurrence after puncture or lesion removal in the early stage, the possibility of FHLT-E should be suspected so as to give early MRI examination. The inflammatory signal changes in the tendon sheath are usually correlated with edema in the surrounding soft tissues, and T1-weighted postgadolinium injection sequences are particularly useful to distinguish the thick tenosynovium from the surrounding structures.…”

Section: Discussionmentioning

confidence: 99%

Effect of extensive tenosynovectomy on diffuse flexor hallucis longus tenosynovitis combined with effusion

Liu

Chen

et al. 2019

J Orthop Surg (Hong Kong)

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Objective: The objective of this study was to examine the clinical and magnetic resonance imaging (MRI) outcomes of extensive tenosynovectomy on patients with diffuse flexor hallucis longus tenosynovitis combined with effusion (DFHLT-E). Methods: Consecutive patients undergoing extensive tenosynovectomy for DFHLT-E in the same foot and ankle center from January 2013 to December 2016 were selected; a total of 14 patients were included in the final analysis. Patients with a minimum 1-year follow-up were evaluated with physical examination, MRI, American Orthopaedic Foot and Ankle Society (AOFAS) clinical midfoot scale, and visual analog scale (VAS) pain scores. Results: The 14 patients were followed up for an average of 15.0 ± 2.3 months (12–18 months). There were no recurrences in all clinical examinations at the final follow-up. The AOFAS score was improved from 61.57 ± 10.70 before surgery to 90.28 ± 9.41 at the final follow-up. The difference was statistically significant ( p = 0.001). The VAS score was improved from 4.00 ± 0.82 before surgery to 0.43 ± 0.53 at the final follow-up ( p < 0.001). MRI examination revealed two patients with small residual and limited effusion with no clinical symptoms. Superficial pin infection was observed in one patient, and two patients had transient neurostimulation. Conclusions: Extensive tenosynovectomy is an effective alternative for the treatment of DFHLT-E with less complications or recurrence.

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Section: Discussionmentioning

confidence: 99%

Effect of extensive tenosynovectomy on diffuse flexor hallucis longus tenosynovitis combined with effusion

Liu

Chen

et al. 2019

J Orthop Surg (Hong Kong)

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“…The axial, coronal, and sagittal reconstructed images and 3D reconstruction (multiplanar reformation, maximum intensity projection, and volume rendering) can provide valuable information regarding the type, morphology, and extent of TCC, which is helpful in its diagnosis and treatment (17). In addition to being able to show the shape of TCC, the advantage of MRI lies in its high signal sensitivity, which allow the sensitive evaluation of bone marrow and soft tissue, including bone marrow edema associated with TCC and tarsal tunnel soft-tissue abnormalities affecting TCC (the flexor hallucis longus tendon, flexor digitorum longus tendon and posterior tibial tendon, as well as the tibial nerve and its branches) (9). Although CT and MRI can visualize the type, morphology, and extent of TCC, CT is a radioactive examination and cannot evaluate the adjacent soft tissue, such as the compression of tibial nerve and the structure of perineurium, while MRI is time-consuming, stressful, and complicated.…”

Section: Discussionmentioning

confidence: 99%

“…With the advent of X-ray, after Slomann observed tarsal coalition on X-ray in 1920 (5), the radiographic signs and properties of TCC were described in multiple literatures (6). The introduction of computed tomography (CT) and magnetic resonance imaging (MRI) improved the understanding of its anatomic characteristics, and CT/MRI have become the established standard to confirm the diagnosis of TCC (7–9).…”

Section: Introductionmentioning

confidence: 99%

The role of ultrasonography in the diagnosis of talocalcaneal coalitions

Wang

et al. 2020

Acta Radiol

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Background Patients with talocalcaneal coalitions (TCC) often undergo computed tomography (CT). However, ultrasonography diagnosis of TCC has been seldom done according to the literature. Purpose To investigate the accuracy of ultrasonography in diagnosing TCC compared to CT. Material and Methods Ninety-seven consecutive patients with a clinical suspicion of TCC were included. Ultrasonography was used to assess the classification and complication of TCC. The main sonographic criteria for a positive diagnosis in cases of osseous coalition were the joint space between the medial surface of talar head and the underlying sustentaculum tali of calcaneus disappearing and being replaced by a continuous hyperechoic bony structure. In cases of fibrous coalition, ultrasonography revealed a reduced space of the joint associated with an irregular, angular appearance of its outline and hypoechoic fibrous tissue inside. These data were compared with CT findings. κ statistic was applied to determine the level of agreement. The sensitivity, specificity, positive and negative predictive values, accuracy, and Youden index of ultrasonography as a diagnostic method were assessed. Results Ultrasonography findings were positive in 20 of 97 patients with a clinical suspicion of TCC. The diagnosis was confirmed by CT in 21 patients. There were one false-positive result and two false-negative results by ultrasonography. The κ value was 0.907. The sensitivity, specificity, positive and negative predictive values, accuracy, and Youden index of ultrasonography were 90.5%, 98.7%, 95.0%, 97.4%, 96.9%, and 0.892, respectively. Conclusion Ultrasonography could be a reliable, accurate, and non-radioactive diagnostic imaging method in diagnosis of patients with suspected TCC.

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“…39 Talocalcaneal coalition results from the fusion of the sustentaculum tali to the talus and can cause PTTS when a bony irregularity protrudes into the tarsal tunnel and compresses the posterior tibial nerve. 40 In cases of idiopathic PTTS, ultrasound is used to detect enlargement of the posterior tibial nerve within the tarsal tunnel. 41 Ultrasonography can also be used to detect variation in the bifurcation of the posterior tibial nerve in order to better identify the precise area of entrapment and aid in targeted treatment.…”

Section: Diagnosismentioning

confidence: 99%

An Update on Posterior Tarsal Tunnel Syndrome

et al. 2022

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Posterior tarsal tunnel syndrome (PTTS) is an entrapment neuropathy due to compression of the tibial nerve or one of its terminal branches within the tarsal tunnel in the medial ankle. The tarsal tunnel is formed by the flexor retinaculum, while the floor is composed of the distal tibia, talus, and calcaneal bones. The tarsal tunnel contains a number of significant structures, including the tendons of 3 muscles as well as the posterior tibial artery, vein, and nerve. Focal compressive neuropathy of PTTS can originate from anything that physically restricts the volume of the tarsal tunnel. The variety of etiologies includes distinct movements of the foot, trauma, vascular disorders, soft tissue inflammation, diabetes mellitus, compression lesions, bony lesions, masses, lower extremity edema, and postoperative injury. Generally, compression of the posterior tibial nerve results in clinical findings consisting of numbness, burning, and painful paresthesia in the heel, medial ankle, and plantar surface of the foot. Diagnosis of PTTS can be made with the presence of a positive Tinel sign in combination with the physical symptoms of pain and numbness along the plantar and medial surfaces of the foot. Initially, patients are treated conservatively unless there are signs of muscle atrophy or motor nerve involvement. Conservative treatment includes activity modification, heat, cryotherapy, non-steroidal anti-inflammatory drugs, corticosteroid injections, opioids, GABA analog medications, tricyclic antidepressants, vitamin B-complex supplements, physical therapy, and custom orthotics. If PTTS is recalcitrant to conservative treatment, standard open surgical decompression of the flexor retinaculum is indicated. In recent years, a number of alternative minimally invasive treatment options have been investigated, but these studies have small sample sizes or were conducted on cadaveric models.

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Tarsal tunnel disease and talocalcaneal coalition: MRI features

Cited by 21 publications

References 26 publications

Effect of extensive tenosynovectomy on diffuse flexor hallucis longus tenosynovitis combined with effusion

Effect of extensive tenosynovectomy on diffuse flexor hallucis longus tenosynovitis combined with effusion

The role of ultrasonography in the diagnosis of talocalcaneal coalitions

An Update on Posterior Tarsal Tunnel Syndrome

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