Acta Chir Orthop Traumatol Cech. 2011; 78(5):468-471 | DOI: 10.55095/achot2011/073

C-Sign and Talocalcaneal CoalitionCase report

Ľ. TOMČOVČÍK*
Klinika úrazovej chirurgie, Univerzitná nemocnica L. Pasteura a LF UPJŠ, Košice

Talocalcaneal coalition is an abnormal bridge between talus and calcaneus, causing pain and restriction of subtalar movement; its incidence is less than 1 %. The signs and symptoms usually become manifest in the second decade of life with ossification of the lesion. They involve flat foot, peroneal muscle spasm, tarsal tunnel syndrome, or valgus tilt of the heel. The sings need not be noticeable and may appear only as tiredness and vague pain in the hind foot after exercise or an easily twisted ankle. The authors describe the case of talocalcaneal coalition in a 20-year-old man, incidentally diagnosed at ankle fracture. The presence of C-sign led to CT examination and the exact diagnosis. Radiological demonstration of this abnormality may be difficult because plain X-ray images in both projections may show normal findings. Literature data report, in addition to C-sign, further secondary signs of talocalcaneal coalition present on lateral radiographs of the ankle joint. Although these signs do not directly point to talocalcaneal coalition, they reveal abnormal anatomy or movement of the joint and may initiate more thorough examination by CT or MRI and the establishment of an exact diagnosis. Therefore, to know the secondary signs and pay attention to them is very useful.

Keywords: talocalcaneal coalition, tarsal, subtalar joint, radiography

Published: October 1, 2011  Show citation

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TOMČOVČÍK Ľ. C-Sign and Talocalcaneal Coalition. Acta Chir Orthop Traumatol Cech. 2011;78(5):468-471. doi: 10.55095/achot2011/073. PubMed PMID: 22094164.
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References

  1. BROWN, R. R., ROSENBERG, Z. S., THORNHILL, B. A.: The C sign: more specific for flatfoot deformity than subtalar coalition. Skeletal. Radiol., 30: 84-87, 2001. Go to original source... Go to PubMed...
  2. CONWAY, J. J., COWELL, H. R.: Tarsal coalition: clinical significance and roentgenographic demonstration. Radiology, 92: 799-811, 1969. Go to original source... Go to PubMed...
  3. CRIM, J. R., KJELDSBERG, K. M.: Radiographic diagnosis of tarsal coalition. AJR Am. J. Roentgenol., 182: 323-328, 2004. Go to original source... Go to PubMed...
  4. DUNGL, P.: Calcaneonavicular coalition and its treatment. Acta Chir. orthop. Traum. čech., 56: 408-418, 1989.
  5. DUNGL, P.: Koalice tarzálních kostí. In: DUNGL, P. et al.: Ortopedie. Praha, Grada Publishing, a.s. 2005, 1097-1098.
  6. KIM, S. H. K.: The C sign. Radiology, 223: 756-757, 2002. Go to original source... Go to PubMed...
  7. LATEUR, L. M., VAN HOE, L. R., VAN GHILLEWE, K. V, GRYSPEERDT, S. S., BAERT, A. L., DEREYMAEKER, G. E.: Subtalar coalition: diagnosis with the C sign on lateral radiographs of the ankle. Radiology, 193: 847-851, 1994. Go to original source... Go to PubMed...
  8. SAKELLARIOU, A., SALLOMI, D., JANZEN, D. J., MUNK, P. L., CLARIDGE, R. J., KIRI, V. A.: Talocalcaneal coalition. Diagnosis with the C-sign on lateral radiographs of the ankle. J. Bone Jt Surg., 82-B: 574-578, 1999. Go to original source...
  9. STASER, J., KARMAZYN, B., LUBICKY, J.: Radiographic diagnosis of posterior facet talocalcaneal coalition. Pediatr. Radiol., 37: 79-81, 2007. Go to original source... Go to PubMed...
  10. ROZANSKY, A., VARLEY, E., MOOR, M., WENGER, D. R., MUBARAK, S. J.: A radiologic classification of talocalcaneal coalitions based on 3D reconstruction. J. Child. Orthop., 4: 129-135, 2010. Go to original source... Go to PubMed...
  11. TANIGUCHI, A., TANAKA, Y., KADONO, K., TAKAKURA, Y., KURUMATANI, N.: C sign for diagnosis of talocalcaneal coalition. Radiology, 228:501-505, 2003. Go to original source... Go to PubMed...