Tarsal sinus: arthrographic, MR imaging, MR arthrographic, and pathologic findings in cadavers and retrospective study data in patients with sinus tarsi syndrome.

Abstract

To evaluate the tarsal sinus by using different imaging techniques and specialized planes. Magnetic resonance (MR) imaging of the tarsal sinus was performed in 10 cadavers. Conventional arthrography of the anterior and posterior subtalar joints was then performed. Tarsal sinus ligaments were evaluated further on initial and reconstructed MR arthrograms along and perpendicular to their axes. Pathologic correlation was performed in five specimens suspected of having tarsal sinus lesions on the basis of initial imaging findings. In 37 patients with a clinical diagnosis of sinus tarsi syndrome, MR images of the ankle were obtained before and after intravenous gadolinium-based contrast material administration and were reviewed to verify the integrity of the tarsal sinus ligaments. Two complete and three partial cervical ligament (CL) tears and one complete interosseous talocalcaneal ligament (ITCL) tear were diagnosed with MR imaging. Only one complete and one partial CL tear were seen after evaluation of both initial and reconstructed MR arthrograms and confirmed with pathologic correlation. In 18 patients, the diagnosis was confirmed at MR imaging, which depicted ITCL and CL tears in 11 patients, isolated CL tears in three patients, ganglia in three patients, and pigmented villonodular synovitis in one patient. Cadaveric study results indicate that initial and reconstructed MR arthrograms along and perpendicular to the ligament axes are potentially useful for further evaluation of individual tarsal sinus structures.