Diagnostic value of radiological signs..86 of tarsal coalitions

Abstract

Tarsal coalition - is an abnormal fusion between two or more tarsal bones which can lead to foot pain, progressive foot deformity, and frequent ankle sprains. Radiological diagnosis of tarsal coalitions on the standard plain radiographs is difficult because of indirect visualization of the fusion zone. Computed tomography is helpful for confirmation of the diagnosis. Purpose: to determine diagnostic value of indirect radiological signs of tarsal coalitions. Material and methods. The analysis of the radiographs of 25 patients with confirmed tarsal coalitions and the radiographs of 37 patients with valgus deformities of feet without tarsal coalitions. Results. The sensitivity and specificity of tarsal coalitions radiological signs were determined. Sensitivity of the "anteater nose" in our study was 92,3%, specificity - 94,31%; C-sign had sensitivity 88,89% and specificity - 77,08%; “talar beak” symptom had sensitivity 36,36 percent and specificity - 97,14%. Conclusion. Sensitivity and specificity of indirect radiological signs of tarsal coalitions determined in our study have sufficient diagnostic value, and computed tomography of the foot should be done for confirmation of diagnosis.

References

[1] Кенис В.М., Никитина Н.В. Тарзальные коалиции у детей (обзор литературы). Травматология и ортопедия России. 2010;(3):159-165

[2] Altman D.G., Bland J.M. Diagnostic tests 1: sensitivity and specificity. BMJ. 1994;308:15.

[3] Bohne W.H. Tarsal coalition. Curr. Opin. Pediatr. 2001;13:29-35.

[4] Crim J.R., Kjeldsberg K.M. Radiographic diagnosis of tarsal coalitions. Am. J. Radiol. 2004;182:323-328.

[5] Harris R.I., Beath T. Etiology of peroneal spastic flat foot. J. Bone Joint Surg. 1948;30-B(4):624-634.

[6] Mosier K.M., Asher M. Tarsal coalitions and peroneal spastic flat foot. J. Bone Joint Surg. 1984;66-A(7): 976-983.

[7] Oestreich A.E., Mize W.A., Crawford A.H., Morgan R.C. Jr. The "anteater nose": adirect sign of calcaneonavicular coalition on the lateral radiograph. J. Pediatr. Orthop. 1987;7(6):709-711.

[8] Slomann H.C. On coalitiocalcaneonavicularis. J. Orthop. Surg. 1921; 3:586-602.

[9] Solomon L.B., Ruchli F.J., Taylor J., Ferris L., Pope R., Hennerberg M. A dissection and computer tomography study of tarsal coalitions in 100 cadaver feet. J. Orthop. Res. 2003;21:352-358.

[10] Taniguchi A., Tanaka Y., Kadono K., Takakura Y., Kurumatani N. C sign for diagnosis of talocalcaneal coalition. Radiology. 2003;228(2):501-505.

[11] Webchsler R.J., Schweitzer M.E., Deely D.M., Horn B.D., Pizzutillo P.D. Tarsal coalition: depiction and characterization with CT and MR imaging. Radiol. 1994;193:447-452.