McNally E G
Department of Radiology, Nuffield Orthopaedic Centre, Oxford, UK.
Skeletal Radiol. 1999 Dec;28(12):691-5. doi: 10.1007/s002560050575.
To define the imaging appearances in three cases of posteromedial subtalar coalition.
Three patients who presented with hindfoot pain were found to have non-osseous coalition involving the posteromedial hindfoot. This entity is distinct from conventional middle facet coalition as the sustentaculum is uninvolved.
Plain radiographs, available in two cases, demonstrated subtle irregularity of the posterior facet. MRI (three cases) demonstrated a mixed bony and cartilaginous mass lying posterior to the sustentaculum. There was trabecular oedema within the mass and adjacent talus, and narrowing of the space between the middle and posterior facets. Prominence and dilatation of the posterior tibial veins with tenosynovitis of the adjacent tibialis posterior tendon was seen. CT demonstrated the bony mass but did not detect the adjacent bony oedema.
Posteromedial subtalar coalition may present with hindfoot pain and stiffness. The presence of a pseudarthrosis posterior to a normal middle facet is characteristic. The abnormality can be difficult to detect on plain radiographs.
明确三例距下关节后内侧联合的影像学表现。
三名后足疼痛患者被发现存在累及后足后内侧的非骨性联合。该实体与传统的中关节面联合不同，因为载距突未受累。
两例患者有X线平片，显示后关节面有细微不规则。MRI（三例）显示载距突后方有一个混合性骨和软骨肿块。肿块及相邻距骨内有小梁水肿，中关节面和后关节面之间的间隙变窄。可见胫后静脉增粗及相邻胫后肌腱腱鞘炎。CT显示了骨肿块，但未检测到相邻的骨水肿。
距下关节后内侧联合可能表现为后足疼痛和僵硬。正常中关节面后方存在假关节是其特征。在X线平片上该异常可能难以检测到。
