Os sustentaculi
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The os sustentaculi or os sustentaculum is a rare accesoryaccessory ossicle of the ankle and a normal anatomical variant.
Epidemiology
EstimatedThe estimated prevalence is approximatlyapproximately 0.3-0.4% 1.
Associations
It has been found in up 24% of talocalcaneal coalitions 2.
Gross anatomy
The os sustentaculi is usually found at the posterior aspect of the sustentaculum tali and is connected to the latter by a fibrous or fibrocartilaginous synchondrosis 3,4.
Variant anatomy
A bony bridge between the the posterior aspect of the sustentaculum and the talus has been suggested as a variant of the os sustentaculi.
Radiographic features
Plain radiograph
The os sustentaculi can be best visualised on an AP view of the ankle with a slight amount of external rotation 4.
CT
The Os sutentaculisustentaculi can be nicely demonstrated on CT and might demonstrate degenerative changes as irregular or hypertophichypertrophic cortical contours, subchondral cysts or vaccumvacuum phenomenon 3.
MRI
On MRI of the ankelankle, the os sustentaculi can be visualised as a separated bony structure from the sustentaculum.
Degenerative changes of the synchondrosis with contour irregularities, sclerosis, and cyst formation might occur. Bone marrow oedema might be present in if the patient experiences symptoms and pain 1-3.
History and etymology
The os sustentaculi was first reported by the German anatomist Wilhelm Pfitzner in 1896 2-6.
Clinical importance
An os sustentaculi can cause pain e.g. as a result of overuse and might be mistaken for a sustentaculum fracture an unusual exostosis or Osos calcanei accesorium secundarium1-5.
Related pathology
The os sustentaculi has been related to an extraarticular talocalcaneal coalition and can cause pain in the setting of overuse 1,2.
-<p>The <strong>os sustentaculi </strong>or<strong> os sustentaculum</strong> is a rare accesory ossicle of the ankle and a <a href="/articles/anatomical-variants">normal anatomical variant</a>.</p><h4>Epidemiology</h4><p>Estimated prevalence is approximatly 0.3-0.4% <sup>1</sup>.</p><h5>Associations</h5><p>It has been found in up 24% of talocalcaneal coalitions <sup>2</sup>.</p><h4>Gross anatomy</h4><p>The os sustentaculi is usually found at the posterior aspect of the sustentaculum tali and is connected to the latter by a fibrous or fibrocartilaginous synchondrosis <sup>3,4</sup>.</p><h4>Variant anatomy</h4><p>A bony bridge between the the posterior aspect of the sustentaculum and the talus has been suggested as a variant of the os sustentaculi.</p><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>The os sustentaculi can be best visualised on an AP view of the ankle with a slight amount of external rotation <sup>4</sup>.</p><h5>CT</h5><p>The Os sutentaculi can be nicely demonstrated on CT and might demonstrate degenerative changes as irregular or hypertophic cortical contours, subchondral cysts or vaccum phenomenon <sup>3</sup>.</p><h5>MRI</h5><p>On MRI of the ankel the os sustentaculi can be visualised as a separated bony structure from the sustentaculum.</p><p>Degenerative changes of the synchondrosis with contour irregularities, sclerosis, and cyst formation might occur. Bone marrow oedema might be present in if the patient experiences symptoms and pain <sup>1-3</sup>.</p><h4>History and etymology</h4><p>The os sustentaculi was first reported by the German anatomist Wilhelm Pfitzner in 1896 <sup>2-6</sup>.</p><h4>Clinical importance</h4><p>An os sustentaculi can cause pain e.g. as a result of overuse and might be mistaken for a sustentaculum fracture an unusual exostosis or Os calcanei accesorium <sup>1-5</sup>.</p><h4>Related pathology</h4><p>The os sustentaculi has been related to an extraarticular talocalcaneal coalition <sup>1,2</sup>.</p>- +<p>The <strong>os sustentaculi </strong>or<strong> os sustentaculum</strong> is a rare <a href="/articles/accessory-ossicles-of-the-foot">accessory ossicle</a> of the ankle and a <a href="/articles/anatomical-variants">normal anatomical variant</a>.</p><h4>Epidemiology</h4><p>The estimated prevalence is approximately 0.3-0.4% <sup>1</sup>.</p><h5>Associations</h5><p>It has been found in up 24% of <a href="/articles/talocalcaneal-coalition">talocalcaneal coalitions</a> <sup>2</sup>.</p><h4>Gross anatomy</h4><p>The os sustentaculi is usually found at the posterior aspect of the <a href="/articles/sustentaculum-tali">sustentaculum tali</a> and is connected to the latter by a fibrous or fibrocartilaginous synchondrosis <sup>3,4</sup>.</p><h4>Variant anatomy</h4><p>A bony bridge between the posterior aspect of the sustentaculum and the <a href="/articles/talus">talus</a> has been suggested as a variant of the os sustentaculi.</p><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>The os sustentaculi can be best visualised on an <a href="/articles/ankle-ap-view-1">AP view of the ankle</a> with a slight amount of external rotation <sup>4</sup>.</p><h5>CT</h5><p>The Os sustentaculi can be nicely demonstrated on CT and might demonstrate degenerative changes as irregular or hypertrophic cortical contours, <a href="/articles/geode">subchondral cysts</a> or <a href="/articles/vacuum-phenomenon-2">vacuum phenomenon</a> <sup>3</sup>.</p><h5>MRI</h5><p>On <a href="/articles/mri-of-the-ankle-an-approach">MRI of the ankle</a>, the os sustentaculi can be visualised as a separated bony structure from the sustentaculum.</p><p>Degenerative changes of the synchondrosis with contour irregularities, sclerosis, and cyst formation might occur. <a href="/articles/bone-marrow-oedema">Bone marrow oedema</a> might be present if the patient experiences symptoms and pain <sup>1-3</sup>.</p><h4>History and etymology</h4><p>The os sustentaculi was first reported by the German anatomist Wilhelm Pfitzner in 1896 <sup>2-6</sup>.</p><h4>Clinical importance</h4><p>An os sustentaculi can cause pain e.g. as a result of overuse and might be mistaken for a sustentaculum fracture an unusual <a href="/articles/exostosis">exostosis</a> or <a title="Os calcanei secundarium" href="/articles/os-calcaneus-secundarius-1">os calcanei secundarium</a> <sup>1-5</sup>.</p><h4>Related pathology</h4><p>The os sustentaculi has been related to an extraarticular talocalcaneal coalition and can cause pain in the setting of overuse <sup>1,2</sup>.</p>
References changed:
- 1. Aparisi Gómez M, Aparisi F, Bartoloni A et al. Anatomical Variation in the Ankle and Foot: From Incidental Finding to Inductor of Pathology. Part I: Ankle and Hindfoot. Insights Imaging. 2019;10(1):74. <a href="https://doi.org/10.1186/s13244-019-0746-2">doi:10.1186/s13244-019-0746-2</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/31363861">Pubmed</a>
- 2. Yun S, Jin W, Kim G et al. A Different Type of Talocalcaneal Coalition With Os Sustentaculum: The Continued Necessity of Revision of Classification. AJR Am J Roentgenol. 2015;205(6):W612-8. <a href="https://doi.org/10.2214/ajr.14.14082">doi:10.2214/ajr.14.14082</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/26587950">Pubmed</a>
- 3. Mellado J, Salvadó E, Camins A, Ramos A, Saurí A. Painful Os Sustentaculi: Imaging Findings of Another Symptomatic Skeletal Variant. Skeletal Radiol. 2001;31(1):53-6. <a href="https://doi.org/10.1007/s002560100431">doi:10.1007/s002560100431</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/11807596">Pubmed</a>
- 4. Bencardino J, Rosenberg Z, Beltran J, Sheskier S. Os Sustentaculi: Depiction on MR Images. Skeletal Radiol. 1997;26(8):505-6. <a href="https://doi.org/10.1007/s002560050275">doi:10.1007/s002560050275</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/9297758">Pubmed</a>
- 5. Bloom R, Libson E, Lax E, Pogrund H. The Assimilated Os Sustentaculi. Skeletal Radiol. 1986;15(6):455-7. <a href="https://doi.org/10.1007/bf00355105">doi:10.1007/bf00355105</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/3764473">Pubmed</a>
- 6. Pfitzner W. Beiträge zur Kenntnis des menschlichen Extremitäten Skeletts. VII. Die Variationen im Aufbau des Fuss-Skeletts. Schwalbes Morphologische Arbeiten 1896; 6:245
- 7. Keles-Celik N, Kose O, Sekerci R, Aytac G, Turan A, Güler F. Accessory Ossicles of the Foot and Ankle: Disorders and a Review of the Literature. Cureus. 2017;9(11):e1881. <a href="https://doi.org/10.7759/cureus.1881">doi:10.7759/cureus.1881</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/29387510">Pubmed</a>
Sections changed:
- Anatomy
Systems changed:
- Musculoskeletal
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Title
was changed:
Accessory sustentaculumsustentacular bone