Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Section 1 Shoulder
- Section 2 Arm
- Section 3 Elbow
- Section 4 Forearm
- Section 5 Wrist
- Section 6 Hand
- Section 7 Hip and Pelvis
- Section 8 Thigh
- Section 9 Leg
- Section 10 Ankle
- Case 60 Posterior impingement
- Case 61 Haglund’s syndrome
- Case 62 Accessory anterolateral facet of the talus
- Case 63 Maisonneuve fracture
- Case 64 Triplane fracture
- Case 65 Peroneal tendon dislocation and calcaneal fractures
- Case 66 Anterior impingement
- Case 67 Peroneocalcaneus internus muscle: false flexor hallucis longus (FHL)
- Case 68 Accessory soleus muscle: a differential for posteromedial ankle mass
- Case 69 Xanthoma of the Achilles tendon
- Section 11 Foot
- Section 12 Tumors/Miscellaneous
- Index
- References
Case 62 - Accessory anterolateral facet of the talus
from Section 10 - Ankle
Published online by Cambridge University Press: 05 July 2013
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Section 1 Shoulder
- Section 2 Arm
- Section 3 Elbow
- Section 4 Forearm
- Section 5 Wrist
- Section 6 Hand
- Section 7 Hip and Pelvis
- Section 8 Thigh
- Section 9 Leg
- Section 10 Ankle
- Case 60 Posterior impingement
- Case 61 Haglund’s syndrome
- Case 62 Accessory anterolateral facet of the talus
- Case 63 Maisonneuve fracture
- Case 64 Triplane fracture
- Case 65 Peroneal tendon dislocation and calcaneal fractures
- Case 66 Anterior impingement
- Case 67 Peroneocalcaneus internus muscle: false flexor hallucis longus (FHL)
- Case 68 Accessory soleus muscle: a differential for posteromedial ankle mass
- Case 69 Xanthoma of the Achilles tendon
- Section 11 Foot
- Section 12 Tumors/Miscellaneous
- Index
- References
Summary
Imaging description
Accessory anterolateral facet of the talus is a normal variation involving the anterolateral aspect of the lateral process of the talus, which articulates with an extended facet of the anterior process of the calcaneus (Figure 62.1). Combined with the extended facet of the calcaneus, this opposing structure looks like an anterior extension of the posterior subtalar joint. Detection on the lateral radiographs may be difficult particularly in the presence of a valgus hindfoot deformity. Cross-sectional studies especially MRI can detect articular cartilage in the interface (Figure 62.2). This variation was seen in 34% of the 79 pediatric cadaveric specimens.
Importance
Painful talocalcaneal impingement associated with this variation has been reported in a small number of pediatric patients with rigid flatfoot. Although tarsal coalitions are the most common etiology of the rigid flatfoot in adolescents and young adults, lateral talocalcaneal impingement associated with accessory anterolateral facet of the talus can be a cause of painful rigid foot. Interestingly the accessory anterolateral facet is commonly associated with dorsal talar beaking (29%).
Typical clinical scenario
Pediatric to young adult patients may present with painful rigid flatfoot deformity. Subtalar motion is restricted with the pain localized to the sinus tarsi. Lateral radiographs may show flatfoot deformity with dorsal talar beaking. CT or MRI may be requested for possible tarsal coalition. Accessory anterolateral facet can be detected on these cross-sectional studies. MRI demonstrates bone marrow edema on both talar and calcaneal sides along the accessory articulation. Surgical resection of accessory anterolateral facet provides improvement in symptoms.
- Type
- Chapter
- Information
- Pearls and Pitfalls in Musculoskeletal ImagingVariants and Other Difficult Diagnoses, pp. 133 - 134Publisher: Cambridge University PressPrint publication year: 2013