Eman Alqahtani1, Evelyne Fliszar2, Donald L Resnick2, Brady K Huang2. 1. University of California, San Diego, 408 Dickinson St., Mail Code 8226, San Diego, CA, 92103, USA. eman.alqahtani@gmail.com. 2. University of California, San Diego, 408 Dickinson St., Mail Code 8226, San Diego, CA, 92103, USA.
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.
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.
Authors: Susan T Mahan; Victoria I Prete; Samantha A Spencer; James R Kasser; Sarah D Bixby Journal: J Foot Ankle Surg Date: 2017 Jul - Aug Impact factor: 1.286
Authors: Jeffrey E Martus; John E Femino; Michelle S Caird; Richard E Hughes; Richard H Browne; Frances A Farley Journal: J Bone Joint Surg Am Date: 2008-11 Impact factor: 5.284