sinus tarsi anatomy and pathology
TRANSCRIPT
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SINUS TARSI
Anatomy and Pathology
Dr. Marcelo Abreu, Porto Alegre, Brazil
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MEDIAL VIEW LATERAL VIEW UCSD RESEARCH LAB
What is the Sinus Tarsi? • Subtalar Joint: Composed by 2 Diarthrodial parts
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• FUNCTION: Stability & Proprioception
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Similar joints with ligamentous part
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Min MIP
CT with MIP reconst
Stability of the Foot
SUPINATION
PRONATION
EXTENSION
FLEXION
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PROPRIOCEPTION will give EQUILIBRIUM
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ROOT OF THE INFERIOR EXTENSOR RETINACULUM
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CERVICAL LIGAMENT
Also called Fick ligament, the primary function is to limit the inversion of the hindfoot
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INTEROSSEOUS TALOCALCANEAL LIGAMENT
Resnick D et al. Tarsal sinus: arthrographic, MR imaging, MR arthrographic, and pathologic findings in cadavers and retrospective study data
in patients with sinus tarsi syndrome. Radiology 2001;219(3):802-10.
The primary function is to oppose eversion of the foot
Interosseous Ligament
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ACUTE LESIONS OF THE SINUS TARSI
Case 1: 20y, M, Acute Inversion of the Ankle: Sprain of the TaloFib, CalcFib
Sinus tarsi ligament tear can be found in association with
lateral ligament complex tears in 53% of ankle sprain
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ACUTE LESIONS OF THE SINUS TARSI
Case 2: 24y, F, Acute Eversion of the Ankle: Sprain of the SPRING lig
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Chronic: Sinus Tarsi Syndrome (STS) Conditions that induce compression of sinus tarsi structures, causing
inflammatory process with adipose and neural impingement.
POSTERIOR TIBIAL TENDON
INJURY (47%) OF STS
Brown, J.E.: The sinus tarsi syndrome. Clin. Orthop., 1960.
Case 3. F, 57y, PTT insuficiency
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Case 4: 68y, F, Flat Foot, PTT insuficiency, DM2, neuropathy (CHARCOUT JOINT)
Sinus Tarsi Syndrome (STS)
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Chronic: Sinus Tarsi Syndrome (STS)
Case 5: 70y, M, chronic pain, Subtalar OA
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Courtesy of Canela C.
Other Pathology of Sinus Tarsi
SYNOVIAL OSTEOCHONDROMATOSIS SYNOVIAL/GANGLION CYSTS
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:
Last Case: M, 36 y, HLAB27 + STS and second digit pain.
Other Pathology of Sinus Tarsi
Spa: PSORIATIC ARTHRITIS
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Summary
• Sinus Tarsi Anatomy (fat, 1 root, 2 ligaments, nerves)
• Acute Lesions: Ankle and Foot Sprains
• Describe ligametous tears (partial/complete): prognosis, treat.
• Chronic Lesions: STS (PTT insuficiency)
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THANK YOU!
Dr. Marcelo Abreu
Porto Alegre, Brazil