What's the most likely diagnosis?

• Lateral foot radiograph of a 45 year-old with foot pain

1. Avulsion fracture of talus
2. Calcaneal compression fracture
3. Tarsal coalition
4. Kohler's Disease
5. Osteoarthritis

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Additional Image

Oblique view of same foot

Answer:

 

3. Tarsal coalition

 

 

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Tarsal Coalition

General Considerations

• Rare (1% incidence)
• Fusion of two or more tarsal bones in the hindfoot (talus and calcaneous) or midfoot (cuboid, navicular and 3 cuneiforms)
• Most common coalitions (90% of total) are
  • Calcaneous and navicular (calcaneonavicular)
• Calcaneous and talus (talonavicular)
• Fusion may be congenital or acquired
• Congenital form is familial
• Autosomal dominant with near complete penetrance
• Bilateral 50% of time
• More common in males than females
• Acquired form may be due to trauma, infection, arthritis, surgery

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