Young female presented with medial ankle region swelling which she noticed a few years back. Plain radiograph shows findings of the talocalcaneal joint coalition.

Ultrasound shows fibrillary soft tissue bridging two bones. There is no ultrasound signature of either echogenic bone or anechoic cartilage.  There is a ganglion sitting on this coalition with its neck extending into the joint. The ganglion abuts one of the veins but not the nerve. The altered contour of talus results in elevation of medial branch of tibial nerve; along with nerve edema.

The coalition is a developmental condition. The coalition can be of three different types: bony, cartilaginous, fibrous. Comparision with the asymptomatic normal side is helpful.