Abstract
Tarsal coalitions are relatively rare diagnoses affecting adolescent patients that typically present with progressive foot pain. Cuboid-navicular coalition, a type of tarsal coalition, is extremely rare with less than 10 reported cases to date. Most prevailing theories reported have described this specific type of coalition as asymptomatic except at specific moments of stress and exercise. The purpose in presenting this case is to demonstrate that cuboid-navicular coalition can be associated with chronic unremitting pain, as in our patient. We present a case of cuboid-navicular fibrocartilaginous coalition in an adolescent patient presenting with chronic foot pain. Furthermore, from an imaging standpoint, radiographic findings are often subtle and radiologists cannot rely on indirect signs such as talar beak in clinching the diagnosis of cuboid-navicular coalition. Instead, abnormal articulation between the cuboid and navicular must be sought.
Highlights
Tarsal coalition presents in 1% of the population, with over 90% resulting from talocalcaneal or calcaneonavicular coalition [1,2,3]
Current ideologies regarding cuboid-navicular coalitions elucidate the belief that this particular type of coalition is usually asymptomatic except at specific moments where activity or exercise can result in pain or peroneal spastic flatfoot [5,6,7]
From an imaging perspective, radiologists often rely upon indirect signs of tarsal coalition on radiography such as the talar beak, which manifests as added bone formation along the dorsum of the talus secondary to abnormal motion of the talonavicular joint
Summary
Tarsal coalition presents in 1% of the population, with over 90% resulting from talocalcaneal or calcaneonavicular coalition [1,2,3]. As much of the current literature points out, the two most common coalitions (talocalcaneal and calcaneonavicular) present as a painful foot in adolescence that can be exacerbated with walking, activity, or any exercise. Current ideologies regarding cuboid-navicular coalitions elucidate the belief that this particular type of coalition is usually asymptomatic except at specific moments where activity or exercise can result in pain or peroneal spastic flatfoot [5,6,7]. The purpose of this paper is to introduce the reader to a case where the rare cuboid-navicular coalition resulted in chronic unremitting pain in the foot that was not predominantly asymptomatic. As our case will show, a radiologist cannot always rely on indirect signs such as the talar beak to make the diagnosis of a tarsal coalition
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