Computerized tomography scan (CT or CAT scan):
Considered the gold standard for diagnosing tarsal coalitions, a CT scan is a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional horizontal and vertical images (called “slices”) of the body.
How do I know if I have a tarsal coalition?
- pain, typically on the outside and top of the foot (though some children have no pain)
- flat feet or a flat foot (though not all children with flat feet have a tarsal coalition)
- rigidity and stiffness in the affected foot.
- muscle spasms.
What does tarsal coalition feel like?
The symptoms of tarsal coalition may include one or more of the following:
Pain (mild to severe) when walking or standing
.
Tired or fatigued legs
.
Muscle spasms in the leg
, causing the foot to turn outward when walking.
Does tarsal coalition show up on xray?
The initial diagnostic study for the evaluation of patients with hindfoot symptoms and suspected tarsal coalition remains
conventional three-view radiography of the foot
. Most calcaneonavicular coalitions are identified on oblique radiographs.
How painful is tarsal coalition?
Some individuals with
tarsal coalition do not experience any pain
. The abnormal connection between two bones in a tarsal coalition prevents what would otherwise be normal movement between the two bones. As consequence, the hindfoot and/or midfoot usually are stiff and immobile in a foot affected by a tarsal coalition.
What can be done for tarsal coalition?
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to reduce pain and inflammation.
- Physical therapy, including massage, range-of-motion exercises and ultrasound therapy.
- Steroid injection(s) into the affected joint to reduce pain and inflammation.
Is tarsal coalition a disability?
Tarsal coalitions
may cause altered foot biomechanics leading to patient disability from osteoarthritis and other sequelae
. While some types of coalition are common, isolated talonavicular coalitions are relatively rare.
Can tarsal coalition be fixed?
Most children with tarsal coalition can
be treated with nonsurgical options
such as orthotics and physical therapy. If your child has severe symptoms, does not respond to nonsurgical treatments, and the condition interferes with their daily activities, doctors may recommend surgery.
What causes tarsal coalition in adults?
Causes. Tarsal coalition is caused by
a gene mutation
. The bones of the feet are divided into three parts: the hindfoot (back of the foot), midfoot (middle of the foot), and forefoot (front of the foot). Tarsal coalition involves the bones in the midfoot and hindfoot.
Can tarsal coalition cause back pain?
Coalitions often cause a rigid flat foot, and that can be a tremendous source of arch pain and fatigue. A severe flat foot may push the heel bone into the ankle bone, and irritate tendons on the outside of the foot. Additionally, coalitions
can produce arthritis in the back part of the foot
, resulting in achy pains.
How common is tarsal coalition?
The two most common sites of tarsal coalition are between the calcaneus and navicular bones, or between the talus and calcaneus bones. However, other joints can also be affected. It is estimated that
one out of every 100 people may have a tarsal coalition
. In about 50% of cases, both feet are affected.
The plantar calcaneonavicular ligament also referred to as spring ligament is
a thick wide band of cartilaginous connective tissue
that supports the medial longitudinal arch of the foot, failure in the spring ligament leads to flat foot deformity.
What is a talar beak?
The term ‘talar beak’ refers to
a flaring of the superior aspect of the talar head
, seen on lateral radiographs.
2
. This is an indirect sign of talocalcaneal coalition and thought to form as a consequence of impaired subtalar joint motion, which results in the navicular overriding the talus.
Can you run with tarsal coalition?
Clinical relevance: Regaining full recreational activity after resection of a tarsal coalition, i.e. running,
may have implications on abnormal foot loading and torque
, thus promoting degenerative changes in the subtalar and adjacent joints.
Is tarsal coalition rare?
Tarsal coalitions are
relatively rare diagnoses affecting adolescent patients
that typically present with progressive foot pain. Cuboid-navicular coalition, a type of tarsal coalition, is extremely rare with less than 10 reported cases to date.
Does tarsal coalition cause plantar fasciitis?
There are many possible causes for foot pain, from
plantar fasciitis
to fractures, foot neuromas and bone spurs. One such cause is a tarsal coalition. Dr. Stuart Katchis, NY-based orthopedic surgeon specializing in the foot and ankle, has treated many young patients with tarsal coalitions.
