EURORAD ESR

Case 10523

Posteromedial subtalar coalition causing tarsal tunnel syndrome and abductor hallucis denervation

Author(s)
I Bares Fernández

Hospital Morales Meseguer (Murcia)
Avenida Marqués de los Vélez S/N
30008 Murcia,
Spain; Email:nbares.ibf@gmail.com
 
Patient
male, 47 year(s)
 
 
  • Figure 1
    Lateral ankle radiograph

    On the lateral ankle (left) radiograph, we can see the C sign, which suggests the existence of a talocalcaneal coalition.

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 2
    Coronal T1-weighted image

    Coronal T1-weighted image shows an overgrowth of the posteromedial subtalar facet and posterior-subtalar joint space narrowing, which are consistent with non osseous posteromedial subtalar coalition.

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Congenital;
     
     
  • Figure 3
    Coronal T1-weighted image

    The posterior tibial neurovascular bundle (inside the yellow circle) is surrounded by inflammatory tissue (intermediate signal intensity) reactive to the coalition.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
  • Figure 4
    Axial T2 fat-satured image

    Axial section trough the tarsal tunnel. T2 fat-supressed image shows multiple cystic lesions compatible with ganglions (yellow circle) and, behind these, the posterior tibial neurovascular bundle (blue circle).

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Cysts;
     
     
  • Figure 5
    Axial T2-fat suppressed image

    Axial T2 fat-satured shows high signal intensity in the abductor hallucis, which means muscle oedema secondary to medial plantar nerve denervation.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Oedema;
     
     
On the lateral ankle (left) radiograph, we can see the C sign, which suggests the existence of a talocalcaneal coalition.
 
Coronal T1-weighted image shows an overgrowth of the posteromedial subtalar facet and posterior-subtalar joint space narrowing, which are consistent with non osseous posteromedial subtalar coalition.
 
The posterior tibial neurovascular bundle (inside the yellow circle) is surrounded by inflammatory tissue (intermediate signal intensity) reactive to the coalition.
 
Axial section trough the tarsal tunnel. T2 fat-supressed image shows multiple cystic lesions compatible with ganglions (yellow circle) and, behind these, the posterior tibial neurovascular bundle (blue circle).
 
Axial T2 fat-satured shows high signal intensity in the abductor hallucis, which means muscle oedema secondary to medial plantar nerve denervation.
 
 
 
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