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Talocalcaneal coalition - bony

Case contributed by Mohamed Saber
Diagnosis certain

Presentation

Right ankle pain and swelling with severe tenderness following a fall.

Patient Data

Age: 15 years
Gender: Male

MRI study shows:

  • a complete bony bar between the talus and calcaneus is seen medially (bony talocalcaneal coalition)
  • patchy bone marrow edema is seen involving the calcaneus and talus elicits low signal in T1 and high signal in STIR & PDFS likely related to the recent trauma
  • obliteration of the normal fat signal of the sinus tarsi seen replaced with soft tissue thickening and edema with associated bone marrow edema involves its roof and floor suggestive of sinus tarsi syndrome
  • sprained calcaneofibular ligament shows abnormal thickening with intrasubstance and surrounding signal changes
  • tibiotalar and subtalar joint effusion with minimal fluid distension of the flexor hallucis longus tendon sheath
  • mild soft tissue edema of the hindfoot

CT study confirms the bony talocalcaneal coalition.

Case Discussion

Talocalcaneal coalition is one of the two most common subtypes of the tarsal coalition, the other being the calcaneonavicular coalition. it may be bony, cartilaginous, or fibrous. Here is a case of the bony subtype.

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