Bilateral Multiple Tarsal Coalitions (Talonavicular and Talocalcaneal Coalitions) with Recurrent Ankle Sprain in an Adolescent

Tarsal coalition is defined as an abnormal bony, cartilaginous, or fibrous union of two or more tarsal bones. The incidence of tarsal coalition is approximately 2% in the general population. Talocalcaneal and calcaneonavicular coalitions are the most common. The talonavicular coalition is a rare entity with an incidence of approximately 1.3% among patients with tarsal coalitions. We present a case of a 12-year-old girl who had talonavicular and talocalcaneal coalitions associated with a recurrent ankle sprain. The talonavicular coalition was asymptomatic, and the talocalcaneal coalition was the cause of ankle pain and recurrent sprain. Surgical resection of the talocalcaneal coalition led to successful clinical and functional outcomes. In conclusion, the possibility of multiple tarsal coalitions should be considered in tarsal coalition patients, and the talocalcaneal coalition should be considered as a differential diagnosis in an adolescent patient with a recurrent ankle sprain.

Arthroscopic treatment for posteromedial talar process fracture (Cedell fracture): a case report

Fracture of the posteromedial talar process (Cedell fracture) is a rare injury and is easily misdiagnosed as a simple ankle sprain. Suspicion should be heightened if specific mechanisms of injury are present, and, in these cases, a CT scan should be performed. Significant ankle pain and disability can result if these injuries are not identified and treated properly. Few cases have been described in the literature, and the efficacy of surgical techniques and approaches for fractures of the posterior talar process remains controversial. We report a 56-year-old man with an acute posteromedial talar fracture treated arthroscopically. This approach provides good access to the posterior ankle compartment, subtalar joint, and extraarticular structures, which may allow fracture reduction and fixation under arthroscopic visualization. Level of Evidence V; Therapeutic Studies; Expert Opinion.

A Solitary Rosai-Dorfman Disease of The Talus: The First Case Report of Bisphosphonate Therapy with Imaging Follow-up

Rosai-Dorfman disease (RDD) manifesting as a solitary osseous lesion especially of talus bone is rare. The authors reported a 31-year-old Thai man who had chronic left ankle pain and the biopsy of his talar lesion demonstrated emperipolesis, the typical histological feature of RDD. He was treated with curettage and adjuvant bisphosphonate and appeared to show improvement in clinical symptoms and radiological evidence. To the authors’ knowledge, this is the first report of an intraosseous RDD lesion treated with bisphosphonate with imaging follow-up. Keywords: Rosai-Dorfman disease; Talus; Solitary; Radiology; Bisphosphonate

Radiological study of Os trigonum and its clinical significance

Background: Os trigonum (OST) is commonly located on the posterior aspect of the talus. It occurs as a result of secondary ossification center failing to fuse with the lateral tubercle of the posterior process of the talus; its incidence varies between 2 and 25%, and is more often bilateral. It occurs as an intra-articular Os, which is most often securely rooted to the lateral tubercle of the talus by a fibrocartilaginous synchondrosis. Aims and Objective: To determine the incidence, morphology, and distribution of Os Trigonum (OST). Materials and Methods: Retrospective 500 lateral foot radiographs view were studied to determine the incidence, morphology, and distribution of OST. Results: Incidence of OST in the present study was 6.6%, with predominantly round or ovoid in shape. OST was located on the posterolateral aspect of the talus. Conclusion: OST can be one of the causative factor responsible for Flexor hallucis longus tendonitis, OST syndrome, which occur in plantarflexion of the ankle, leading to compression of the OST between the distal tibia and the calcaneus. Hence, knowledge regarding the incidence, morphology, and distribution of OST is important for the radiologist, orthopedic surgeons to arrive at a correct diagnosis, which aids in the management of cases presenting with complaints of posterior ankle pain.

Observe Athlete’s Ankle Pain and Ankle Joint Muscle Characteristics Based on Microscope Images

Objective. To observe the characteristics of ankle pain and ankle joint muscle by microscope. Methods. In a sports university, 15 athletes above grade 2 were randomly selected as the experimental group, and 15 nonathletes were randomly selected as the control group. The experiment mainly included foot shape test, standard scaphoid height test, ankle range of motion test, ankle muscle emg test, and other experimental procedures. Medical microscopic image processing is a new technology developed in the past thirty years, which has brought great progress for mankind to understand and transform nature. Among them, the image processing and recognition of tumor cell microscopic images are one of the research focuses on the use of computers to process and recognize medical images. Results. In the test of ankle range of motion, when the angular velocity was the same as 60°/s, compared with the control group, the difference value of bilateral flexor peak moment in the experimental group was large, and the difference between the two groups was significant ( P < 0.05 ), with statistical significance. As the angular velocity dropped from 240°/s to 60°/s, 30 members of the experimental group and control group also experienced a decrease in the bilateral ankle isokyclic muscles, reflecting their lack of ankle strength. On the other hand, the muscle strength of the ankle joint in the experimental group was relatively small, and the difference between the two groups was significant ( P < 0.05 ). During the exercise, some members of the experimental group suffered from ankle pain, which resulted in insufficient strength of the muscles of the ankle joint, resulting in the interruption of the experiment. In the emg test of ankle muscles, the effective discharge values of preexcitation current of tibial anterior muscle before and after exercise were 104.6 ± 26.5 and 129.2 ± 38.1 , respectively, with significant difference and statistical significance. In the foot morphology test and the standard scaphoid height test, the difference between the two groups was not significant ( P > 0.05 ), and there was no statistical significance. Conclusion. Microscope based on athlete’s foot and ankle pain and ankle muscle characteristics to improve the accuracy of the observation, with the help of a microscope, you can see the details of a doctor are invisible to the naked eye and can record the relevant data in time in order to observe the late, for athlete’s foot and ankle pain relief and enhanced ankle muscles provide data support.

Gouty tophus as a rare cause of a Hepple stage V osteochondral lesion of the talus

Background Talus osteochondral lesion is commonly associated with trauma, avascular necrosis or even genetic factors, but gouty tophus as a cause of Hepple stage V type talus osteochondral lesion is rare. Case presentation Here, we report a case of an 18-year-old man who complained of left medial deep ankle pain on ambulation. This young man had an extreme liking of sea food rich in purines and also sugar-sweetened drinks. He was diagnosed with a Hepple stage V type talus osteochondral lesion and was treated with medial malleolus osteotomy and an osteochondral graft. The talus osteochondral lesion was found to be a gouty tophus and was completely removed. Hypouricemic therapy was prescribed for 2 months, which allowed the patient to walk with a visual analogue score (VAS) score of 1. He was followed up for 12 months. Conclusions Young people with an extreme liking of sea food rich in purines and also sugar-sweetened drinks may be at a risk of developing gout. Acute onset of ankle atraumatic pain, swelling with a high level of serum uric acid and a talus osteochondral lesion with cyst formation should make physicians consider a diagnosis of gout.

Role of ultrasonography in assessment of painful ankle

Background Ankle disorders are a relatively common pathological condition, and ankle injuries account for approximately 14% of sports-related orthopedic emergency visits. Various imaging modalities can be used to make a diagnosis in cases of ankle pain; however, ultrasound (US) has several benefits for the evaluation of ankle pain, especially in the tendons, ligaments, and nerves of the ankle. Aim of the work to assess the role of high resolution US as a valuable tool in the depiction of causes of ankle joint pain. Patient & methods our study is a cross sectional descriptive screening study including 25 patients with ankle joint pain (acute or chronic), post traumatic or not with no age or sex predilection. Results The study included 15 (60%) males and 10 (40%) females. Their age ranged from 10 to 60 years with a mean age of 33.84±13.31years. Chronic ankle pain was the most common presenting symptom in 15 patients (60%) whereas 10 (40%) patients presented with acute ankle pain after trauma. The posterior ankle compartment was the most common affected compartment (24%) of cases. About 7 cases (28%) were presented by ankle swelling with or without pain. Conclusion In conclusion, MSK US is useful in detecting the underlying causes of ankle pain and still it has the potential to offer more valuable data if it is well mastered by the sonographers.

Primary Rosai-Dorfman Disease in 39-Year-Old Woman With Osseous Tibial Lesion Manifestion: A Case Report and Literature Review

Rosai-Dorfman disease (RDD), otherwise known as sinus histiocytosis with massive lymphadenopathy (SHML), is a very rare and typically benign disorder of unknown etiology with <10% bone involvement. The report is of a case seen at the authors’ hospital of a patient presenting with several months’ onset unspecified nontraumatic ankle pain. There was no physical mass or lymphadenopathy appreciated on examination. Plain radiographs and magnetic resonance images demonstrated an osteolytic lesion at the medial malleolus. Biopsy revealed the diagnosis of intraosseous manifestation of Rosai-Dorfman disease.