Ankle and Foot 47 - Department of Radiology - University of ...

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2290 VII Imaging of the Musculoskeletal System A Figure 47-94. Calcaneonavicular coalition in an 11- year-old with right foot pain. A, Oblique radiograph shows the abnormal joint in this nonosseous coalition (arrowheads in magnified dashed box). B, Axial oblique CT scan through the bottoms of the talar heads (H) shows the symptomatic coalition on the right foot (black arrowhead) between the elongated anterior process of the calcaneus (APC) and the navicular (N). Incidentally seen is an asymptomatic coalition on the left (white arrowhead) between the abnormally broad APC and the navicular. C, Axial oblique CT scan slightly plantar to B. On the right foot is the symptomatic abnormal joint (arrowhead) between the broad APC and the navicular. On the left is an extra bone, an os calcaneus secondarius (OCS), articulating with both the APC and navicular. B C Ch047-A05375.indd 2290 9/9/2008 5:35:45 PM
47 Ankle and Foot 2291 47 D E F G Figure 47-94, cont’d D, Sagittal CT scan of the right foot shows the nonosseous coalition (arrowhead) between the navicular and APC. E, Sagittal CT scan of the left foot shows the OCS between the navicular and APC. Surgery was elected. F and G, Fluoroscopic spot views were obtained at the beginning (F) and end (G) of the resection. The pointer in F is a metal instrument that the surgeon uses to localize the coalition fluoroscopically. The white rectangle in G outlines the resection site. H, Postoperative radiograph shows the calcaneus and navicular no longer in contact with each other (white rectangle). H Ch047-A05375.indd 2291 9/9/2008 5:35:47 PM
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Ankle and Foot 47 - Department of Radiology - University of ...

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