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15 Y/O with Ankle Pain

HISTORY: 15yo male, pain with walking, chronic. Referring physician indicated talonavicular dislocation and postierior tibial tendon rupture as well.

DX: Accessory anterolateral talar facet, with MRI findings of osseous impingement including bone marrow edema and sclerosis. This is seen in conjunction with hindfoot valgus and pes planus. There is attenuation/stretching of the spring ligament (superomedial calcaneonavicular ligament) without tear. There is mild loss of sinus tarsi without sinus tarsi inflammation.

Literature suggests that this accessory facet has an association with symptomatic children tend to also have pes planus. Relative to other congenital/developmental pathology, this one doesn’t seem to get the attention it deserves.

Read the JBJS Article Abstract here.


Martus J E, Femino J E, Caird M S, Hughes R E, Browne R H, Farley F A. Journal of Bone and Joint Surgery: 2008 – vol. 90, pp. 2452-2459.