Fracture of mid-tarsal joint (Chopart joint)

Case contributed by Dr Tim Luijkx

Presentation

Tripped. Pain located at the level of the ankle.

Patient Data

Age: 60 years
Gender: Female
X-ray

Initial X-ray at Emergency Department

Because pain was mainly located at the ankle, standard AP and lateral ankle views were performed.

Normal tibiotalar joint and no joint effusion at this level. Slight irregularity on medial side of navicular, but a fracture cannot be substantiated.

Although no fracture was demonstrated, based on clinical suspicion foot and ankle were casted. 

CT

CT of ankle and foot 10 days later

Continuing pain. CT was performed to evaluate if any fracture could be visualised.

There appeared to be extensive comminutive fracturing of several structures:

Case Discussion

These fractures involve the cuboideonavicular joint and the mid-tarsal joint, also known as the transverse tarsal joint or Chopart's joint, which consists of two joints:

  • articulation between calcaneus and cuboid (calcaneocuboid joint
  • articulation between talus, navicular and calcaneus (talocalcaneonavicular joint), which is a ball (talus) and socket (concavity of posterior surface of navicular and anterior articular surface of calcaneus) joint

This case demonstrates the possible underestimation on conventional X-ray imaging of fracture extent and the importance of clinical findings when considering additional imaging investigations.

PlayAdd to Share

Case information

rID: 30686
Case created: 28th Aug 2014
Last edited: 31st Aug 2017
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.