Pedal coalitions Flashcards
What does the Harris & Beath axial projection show?
Lateral projection that shows posterior and middle facet
What does the Ischerwood identifiy? What projection is this?
lateral oblique projection that shows the anterior facet of STJ; nwb!!;
Synchondrosis
cartilaginous coalition
synostosis
osseous coalition
syndesmosis
fibrous coalition
What is the most common pedal coalition?
fusion of middle/distal phalanx of 5th digit
What is the most common tarsal coalition
talo-calcaneal coalition
what is the least common tarsal coalition
talo-navicular coalition
What age does that talocalcaneal manifest
12-16 yo
what ages does the talonavicular manifest
3-5 yo
what ages does the calcanealnavicular manifest?
8-12 yo
what are the signs and symptoms of tarsal coalitions
stiffness/decreased DOM pain pronation cavus deformity rearfoot valgus anterior/posterior tibial spasm Peroneal spasm-lateral calf pain
Incidence of tarsal coalitions
More common in males(sports, occupation)
- BILATERAL IN 50% of patients
- race doesn’t matter
Most common STJ(talo-calcaneal) coalition
middle facet
signs and symptoms of Talonavicular coalition
putter sign
Pt comes in with an Ant-eater sign what do they have?
Calcaneonavicular coalition
What projection is best for identifying a talonavicular coalition?
Anteriorposterior; medial oblique
What projection is best for identifying a calcaneonavicular coalition?
Lateral oblique; lateral
Broden identifies what? what view is it?
a medial oblique film that shows posterior STJ
Halo sign
altered calcaneal trabecular patten secondary to the altered compression forces from the talus
who discovered the radiograph
William Rankin
True coalition
intra-articular fusion
extra articular fusion of two bones
Bar/bridge coalition
coalition
The union of things separate into a single body
Complete coalition
osseous union and limits all motion
-no pain
incomplete coalition
union of fibrous or cartilaginous tissue
-pain
osseous projection from one or more bones which
limits motion but does not produce a union of parts
Rudimentary coalition
How do Apert’s syndrome and Nievergelt-Pearlman Syndrome differ from each other
Apert’s Syndrome • Massive targsal coalition • Craniosynostosis • Midfacial hypoplasia • Broad and distal phalanx of thumb and hallux Nievergelt-Pearlman Syndrome • Synphalangism • Carpal fusion • Atypical clubfoot with massive tarsal fusions • Congenital dislocation of radial heafd • Conduction deafness • Ball and socket ankle joints
metatarsal cuneiform is best seen by what projection?
oblique
Calcaneocuboid is best seen by what projection
lateral oblique
What are the standard degrees for Harris and Beath?
30-35-40-45
lateral projection
Isolated fusions usually occur between bones of ? those associated with other abnormalities occur across
the same row (distal to proximal),
rows (medial to lateral)
Phocomelia
defective developmet of arms or legs; feet or hands are attached close to the body (flippers)
Hemimelia
underdevelopment of an extremity or part
Synphalangism
webbing of toes
-congenital fusion of proximal or distal interphalangeal jionts
Best projection to see Talocalcaneal(middle & posterior facet)
Harris and Beath
Best projection to see Talocalcaneal (Anterior facet)
lateral oblique, isherwood(oblique lateral dosoplantar)
Best projection to see Talocalonavicular
Anterior Posterior
Medial oblique
Best projection to see Calcanonavicular
Lateral oblique
Lateral
Signs and symptoms of Talocalcaneal
Halo sign
Talar breaking
Signs and symptoms of Talonavicular
Putter
Signs and symptoms of Calcanonavicular
Ant-eater
what is talar breaking?
2nd stress on talonavicular ligament, 2 deg impingement of the navicular on the head of the talus in dorsiflexion
when setting up Harris & beath what do u have to remember?
THe posterior and middle facet should be parallel.
Radiographic features of subtalar joint(talocalcaneal jt) coalition
Talar breaking Narowing of posterior talocalcanelal joint space Round of lateral talar process Middle STJ not visible Halo effect
