Abstract
Objective
The accessory anterolateral talar facet (AALTF) is a developmental entity described as a potential cause for rigid, painful flat foot. This study evaluates the possible association between the AALTF and other flat foot etiologies, specifically different types of tarsal coalitions.
Materials and methods
We evaluated patients with tarsal coalition or sinus tarsi syndrome for an AALTF on CT and MRI. Exclusion criteria included acute ankle trauma, recent surgery, motion or metal artifacts. We evaluated the AALTF length and height, and the lateral talocalcaneal structures for associated findings. The presence of calcaneonavicular (CNC), intra-articular middle facet talocalcaneal (MFTCC), posterior facet talocalcaneal (PFTCC), extra-articular posteromedial talocalcaneal (EATCC) and other rare coalitions were also evaluated.
Results
One hundred eighty-seven patients were included (age range 14–91 years; mean ± SD; 50 ± 17 years). The AALTF prevalence in the study population was 31.55% (59/187), 40.91% in men, and 23.23% in women. The AALTF average length was 4.5 ± 1.1 mm, and average height was 8.9 ± 3.4 mm. The AALTF was found to be significantly associated with lateral talocalcaneal osseous changes such as cortical thickening and cystic changes (34/59 and 24/59 respectively, P < 0.01). The AALTF was also found to be significantly associated with sinus tarsi edema on MRI (45/52, P < 0.05). The AALTF was also significantly associated with EATCC (19/59, P < 0.01) and MFTCC (7/59, P < 0.05). No significant association was found with CNC, PFTCC or other rare coalitions.
Conclusion
The AALTF is common and significantly associated with some tarsal coalitions, specifically EATCC and MFTCC. When an AALTF or coalition is identified, special attention should be made to evaluate for other associated pathologies, as this could potentially affect management.
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References
Martus JE, Femino JE, Caird MS, Hughes RE, Browne RH, Farley FA. Accessory anterolateral facet of the pediatric talus: an anatomic study. J Bone Joint Surg Am. 2008;90(11):2452–9.
Martus JE, Femino JE, Caird MS, Kuhns LR, Craig CL, Farley FA. Accessory anterolateral talar facet as an etiology of painful talocalcaneal impingement in the rigid flatfoot: a new diagnosis. Iowa Orthop J. 2008;28:1–8.
Sewell RB. A study of the astragalus. J Anat Physiol. 1904;38(Pt 3):233–47.
Newman JS, Newberg AH. Congenital tarsal coalition: multimodality evaluation with emphasis on CT and MR imaging. Radiographics. 2000;20(2):321–32 quiz 526-327, 532.
Hirano T, Niki H, Akiyama Y, Beppu M. Anatomical characteristics of the accessory antero-lateral talar facet. J Orthop Sci. 2015;20(1):124–8.
Trattnig S, Breitenseher M, Haller J, Heinz-Peer G, Kukla C, Imhof H. Sinus tarsi syndrome. MRI diagnosis. Radiologe. 1995;35(7):463–7.
Aydingoz U, Melih Topcuoglu O, Gormez A, Cankurtaran T, Dilara Topcuoglu E, Bilge Ergen F. Accessory anterolateral Talar facet in populations with and without symptoms: prevalence and relevant associated ankle MRI findings. AJR Am J Roentgenol. 2016;207(4):846–51.
Kulik SA Jr, Clanton TO. Tarsal coalition. Foot Ankle Int. 1996;17(5):286–96.
Linklater J, Hayter CL, Vu D, Tse K. Anatomy of the subtalar joint and imaging of talo-calcaneal coalition. Skelet Radiol. 2009;38(5):437–49.
Kumar SJ, Guille JT, Lee MS, Couto JC. Osseous and non-osseous coalition of the middle facet of the talocalcaneal joint. J Bone Joint Surg Am. 1992;74(4):529–35.
Moe DC, Choi JJ, Davis KW. Posterior subtalar facet coalition with calcaneal stress fracture. AJR Am J Roentgenol. 2006;186(1):259–64.
Takakura Y, Kumai T, Takaoka T, Tamai S. Tarsal tunnel syndrome caused by coalition associated with a ganglion. J Bone Joint Surg Br. 1998;80(1):130–3.
Mahan ST, Prete VI, Spencer SA, Kasser JR, Bixby SD. Subtalar coalitions: does the morphology of the subtalar joint involvement influence outcomes after coalition excision? J Foot Ankle Surg. 2017;56(4):797–801.
Jayakumar S, Cowell HR. Rigid flatfoot. Clin Orthop Relat Res. 1977;(122):77–84.
Donovan A, Rosenberg ZS. Extraarticular lateral hindfoot impingement with posterior tibial tendon tear: MRI correlation. AJR Am J Roentgenol. 2009;193(3):672–8.
Funk DA, Cass JR, Johnson KA. Acquired adult flat foot secondary to posterior tibial-tendon pathology. J Bone Joint Surg Am. 1986;68(1):95–102.
Gray DJ, Gardner E, O’Rahilly R. The prenatal development of the skeleton and joints of the human hand. Am J Anat. 1957;101(2):169–223.
Sarrafian SK. Anatomy of the foot and ankle. 3rd ed. Philadelphia: Lippincott, William and Wilkins; 2011.
Hattori K, Sakuma E, Nakayama M, Kozaki A, Wada I, Otsuka T. An anatomic study of the accessory anterolateral talar facet. Folia Morphol (Warsz). 2015;74(1):61–4.
Conway JJ, Cowell HR. Tarsal coalition: clinical significance and roentgenographic demonstration. Radiology. 1969;92(4):799–811.
Niki H, Hirano T, Akiyama Y, Beppu M. Accessory talar facet impingement in pathologic conditions of the peritalar region in adults. Foot Ankle Int. 2014;35(10):1006–14.
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Alqahtani, E., Fliszar, E., Resnick, D.L. et al. Accessory anterolateral talar facet associated with tarsal coalition: prevalence and cross-sectional characterization. Skeletal Radiol 49, 417–424 (2020). https://doi.org/10.1007/s00256-019-03293-y
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DOI: https://doi.org/10.1007/s00256-019-03293-y