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Macrodactyly
Joseph Junewick, MD FACR
over 6 years ago
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Calcaneocuboid Coalition

Case Detail

Anatomy: Musculoskeletal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: over 4 years ago
Updated: over 4 years ago
Tags: PEDS
Modality/Study Types: CR CT
Activities:
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History

4 year old with pain and poor range of motion.


Case Images


Diagnosis

Calcaneocuboid Coalition

Findings

CR – Lateral radiograph shows osseous fusion of the calcaneus and cuboid bones.

CT – Axial and volume rendered 3D images show incomplete segmentation of the calcaneus and cuboid bones.

Discussion

Tarsal coalition refers to a union between two or more bones in the mid and/or hindfoot. It occurs in approximately 6% of the population and although congenital, patients typically present in adolescence. There is a significant male predilection. About half are bilateral, even if symptomatic on only one side. Multiple coalitions can be present in one foot. Pes planus is a common feature.

Tarsal coalition is believed to be the result of incomplete or faulty segmentation during development. Fusion may be osseous (synostosis), cartilaginous (synchondrosis), or fibrous (syndesmosis).

Approximately 90% of tarsal coalitions involve the talocalcaneal or calcaneonavicular joints. Calcaneonavicular coalitions are the most commonly encountered type, followed closely by talocalcaneal and calcaneonavicular coalitions. Calcaneonavicular coalitions are more readily diagnosed with conventional radiography, which may contribute to their reported higher prevalence. Talonavicular coalitions are far less common, and many are asymptomatic. Calcaneocuboid, cubonavicular and naviculocuneiform coalitions are very rare.

Reference

Newman JS, Newberg AH. Congenital Tarsal Coalition: Multimodality Evaluation with Emphasis on CT and MR Imaging. Radiographics (2000); 20:321-332.



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