Accessory Anterolateral Talar Facet Research Articles

Are enlarged peroneal tubercle and accessory anterolateral talar facet associated with calcaneal spur?

BackgroundAs the anatomical variations of the foot, enlarged peroneal tubercle (EPT) and accessory anterolateral talar facet (AALTF) have attracted the attention of foot surgeons in recent years. However, EPT and AALTF have not been examined for a relationship with calcaneus spur (CS) as a common osteophyte.MethodsThe subjects were 369 individuals who died in northeastern Thailand and were preserved as skeletal specimens. The authors examined for the presence of left and right EPT, AALTF, and calcaneus spur (CS). We divided the EPT (+) group with EPT and the EPT (-) group without it and also divided the AALTF (+) group with AALTF and the AALTF (-) group without it. The age at death and the presence of CS were compared statistically between the EPT (+) and EPT (-) groups and between the AATLF (+) and AALTF (-) groups.ResultsOut of the total 369 cases, EPT was found in 117 cases (31.7%), AALTF was positive in 91 cases (24.7%), and CS was found in 194 cases (52.3%). In comparison between EPT (+) and EPT (-) groups, CS was significantly higher (p < 0.0001) in the EPT (+) group, but there was no significant difference in age at death. In comparison between AALTF (+) and AALTF (-) groups, there was no significant difference in age at death or CS.ConclusionThis study showed a strong relationship between EPT and CS, and the prevalence of EPT and AALTF by age in Thailand was first reported. We believe it helps to know the pathogenesis and biomechanism of EPT and AALTF.Trial registrationNot applicable.

How accurate is MRI for diagnosing tarsal coalitions? A retrospective diagnostic accuracy study

ObjectivesThis study aimed to evaluate the diagnostic accuracy, inter-reader agreement, and associated pathologies on MR images of patients with confirmed TC.Methods and materialsIn this retrospective study, 168 ankle MRI exams were included, consisting of 56 patients with clinically or surgically confirmed TC and 112 controls without TC, matched for age and sex. Images were analyzed independently by three radiologists blinded to clinical information. The evaluation criteria included the presence, type, and location of TC, as well as associated pathologies. After calculating diagnostic accuracy and the odds ratio of demographic data and anatomic coalition type for associated pathologies, inter-reader agreement was assessed using kappa statistics.ResultsThe majority of TCs were non-osseous (91.1%) and located at the calcaneonavicular (33.9%) or talocalcaneal joint (66.1%). Associated pathologies included adjacent and distant bone marrow edema (57.1% and 25.0%), osteochondral defect of the talar dome (OCD, 19.6%), and joint effusion (10.7%) and accessory anterolateral talar facet (17.9%). Talar OCD was associated with increased patient age (p = 0.03). MRI exhibited a cumulative sensitivity and specificity of 95.8% and 94.3% with almost perfect inter-reader agreement (κ = 0.895).ConclusionMRI is a reliable method for detecting tarsal coalition and identifying commonly associated pathologies. Therefore, we recommend the routine use of MRI in the diagnostic workup of patients with foot pain and suspected tarsal coalition.Clinical relevance statementMRI is an accurate and reliable modality for diagnosing tarsal coalitions and detecting associated pathologies, while improving patient safety compared to computed tomography by avoiding radiation exposure.Key Points• Despite the technological progress in magnetic resonance imaging (MRI), computed tomography (CT) is still regarded as the gold standard for diagnosing tarsal coalition (TC).• MRI had a cumulative sensitivity of 95.8% and specificity of 94.3% for detecting tarsal coalition with an almost perfect inter-reader agreement.• MRI demonstrates high accuracy and reliability in diagnosing tarsal coalitions and is useful for identifying associated pathologies, while also improving patient safety by avoiding radiation exposure.

Treatment of calcaneonavicular coalition accompanied by an accessory anterolateral talar facet.

The association of accessory anterolateral talar facet (AALTF) and tarsal coalition has been reported recently. However, there is no report in the literature examining the clinical outcomes of operative treatment simultaneously addressing both AALTF and tarsal coalition. In this case series, we report the functional outcomes of operative treatment for both AALTF and calcaneonavicular coalition (CNC). Four male patients were admitted to our institution with foot pain. Radiographic examination revealed CNC and accompanying AALTF in all patients. Five feet of these four patients were operated simultaneously for AALTF and CNC. At the final follow-up, the mean Visual Analog Scale score was 1.7±2.4 (range, 0 to 5.5), the mean American Orthopedic Foot and Ankle Society score was 89.6±11.5 (range, 69 to 97), and the mean Foot Function Index was 15.4±19.1 (range, 0 to 43). In conclusion, simultaneous resection of CNC with AALTF seems to have good postoperative clinical outcomes. As AALTF can emerge along with CNC, every patient scheduled for CNC resection should be evaluated for AALTF.

Accessory Talar Facet Impingement and Sinus Tarsi Pain Associated With Accessory Anterolateral Talar Facet.

Sinus tarsi pain caused by accessory talar facet impingement (ATFI) owing to accessory anterolateral talar facet (AALTF) is not well documented. We evaluated prevalence of AALTF and differences of magnetic resonance imaging (MRI) findings between persons with and without sinus tarsi pain, and investigated the relevant association between MRI findings and sinus tarsi pain in persons with AALTF. We performed a case-control study on 120 ankles with sinus tarsi pain and 120 age- and gender-matched ankles without sinus tarsi pain. As MRI findings, bone marrow edema (BME), sinus tarsi fat obliteration (STFO), calcaneal cyst, talocalcaneal coalition, Gissane angle, talar inferolateral surface (TILS) angle, and calcaneal cortical thickness (CCT) were evaluated. The MRI findings were compared between persons with and without sinus tarsi pain, and between persons with and without AALTF. Among persons with AALTF, MRI findings were compared between those with and without sinus tarsi pain. Relevant association was evaluated between MRI findings and sinus tarsi pain in persons with AALTF. Presence of AALTF, BME, and STFO were significantly higher in the group with sinus tarsi pain. The Gissane angle was significantly smaller, and the TILS angle and CCT were significantly larger in the group with sinus tarsi pain. The BME (OR 7.571, CI 1.453-39.446) and small Gissane angle (OR 0.891, CI 0.804-0.986) were significantly associated with sinus tarsi pain in persons with the AALTF. The study provides evidence for ATFI related to impingement of an AALTF associated with talocalcaneal BME. Level III, case-control study.

Arthroscopic Mobilization of the Ankle-subtalar Joint Complex Using a Novel “Infra-fibula-tip” Portal

Category:Arthroscopy; HindfootIntroduction/Purpose:As a minimally invasive surgical option for posterior ankle/subtalar pathologies, the prone hindfoot endoscopy (a.k.a. Van-Dijk’s method) has been becoming the ‘gold standard’ technique. While this technique holds advantage regarding good orientation and safety handling of posteromedial pathologies, it limits access to the anterolateral part, therefore inconvenient when simultaneously dealing with anterior and posterior pathologies. Recently, we have introduced a novel ‘infra- fibula-tip (IFT)’ portal, which permits wide access to the posterior talocalcaneal joint (PTCJ), from anterolateral to posteromedial, with a patient positioned in supine or semi-lateral. The present study reviewed clinical outcomes of a case series of arthroscopic hindfoot mobilization using this new surgical technique, so as to document its clinical utility.Methods:The sequence of surgical procedures is as follows; - Create an IFT portal, from a small incision immediately distal to the fibular tip, through the peroneal tendon sheath (anterior to the tendons, but posterior to the calcanofibular ligament), toward the posterior porch of PTCJ.- Inserting a 30-deg 2.7mm scope to the posterior porch, and broadly observing posterior intraarticular findings.- Gently moving the scope to the anterolateral porch, and broadly observing anterolateral intraarticular findings.- Creating an anterolateral (AL) portal under arthroscopic guidance.- Creating a PL portal at immediately lateral to the Achilles tendon, with guidance of a blunt rod inserted from the AL portal (gently advanced posteriorly through the lateral recess and penetrated the rod toward subcutis).- Executing posterior procedures from the PL portal, while observing from the IFT portal. Executing anterolateral procedures working from the AL portal, while observing from the IFT portal.Results:A total of 7 cases underwent the procedure of interest to date. Subtalar osteoarthritis (OA) occurred in all, with accessory anterolateral talar facet (AALTF) impingement in 3. Ankle OA occurred in 3, with anterior bony impingement in 2. Preceding pathologies included peri-ankle intraarticular fractures (4), talocalcaneal coalition (2), and neurogenic varus foot (1). Mobilization procedures included lateral-to-posterior PTCJ debridement (7), coalition release (2), AALTF removal (3), sinus debridement (2), posterior ankle capsule release (2), anterior ankle debridement (2), talonavicular debridement (1), and Achilles tendon lengthening (1). The surgery duration ranged from 65 to 245 minutes. Postoperatively, of 4 cases followed more than 6 months, remarkable motion improvement (10 degrees or more) occurred in 3, and every case reported symptom relief.Conclusion:The IFT portal accesses the middle of the PTCJ, with a short skin-to-joint distance, allowing flexible exploration of both the posterior and anterior porches. Posteriorly, ability of direct intraarticular access (without extraarticular shaving) reduces surgical invasion, as well as the risk of potential neurovasucular injury. Anteriorly, it helps secure good triangulation for handling sinus pathologies. Since subtalar arthroscopy using the IFT portal is doable in a supine or semi-lateral position, anterior ankle arthroscopy could be simultaneously executed. Arthroscopic hindfoot mobilization using this technique appears to be efficient for dealing with ankle/subtalar contracture due to combined anterior and posterior pathologies.

Accessory anterolateral talar facet: analysis of the morphologic features on MRI.

To analyze the morphologic features of accessory anterolateral talar facet (AALTF) on MRI that can assist in detecting this entity, identify any associated structural changes and also define its MRI prevalence. Two radiologists retrospectively evaluated 140 ankle MRI scans for the presence of AALTF, complimentary anterior calcaneal extension facet and angle of Gissane measurement. One observer evaluated the scans for other structural details including AALTF length, cartilage thickness, bone marrow edema, hind foot coalition and talar beaking. There was a good inter-observer agreement for the detection of AALTF on MRI (Kappa = 0.64). AALTF was present in 33 out of 140 (23.6%) scans. There was no significant difference in the prevalence of AALTF between male and female subjects (P = 0.71). No significant difference in age between those with and those without AALTF (P = 0.96). Angle of Gissane was significantly smaller in ankles with AALTF (P = 0.0367, observer 1 and 0.0003, observer 2). AALTF had a mean length of 7mm and was covered with cartilage in 25/33 (75.8%) with mean cartilage thickness of 1.4mm. Complimentary cartilage covered anterior calcaneal facet was demonstrated in 10/33 (30.3%) and had a mean cartilage thickness of 2.5mm. Talar beaking was more prevalent in ankles with AALTF showing an anterior calcaneal extension facet than those without the latter feature (P = 0.02). AALTF is a frequently observed feature on ankle MRI, with good inter-observer reliability for its detection. When present, it is often opposed by a cartilage covered anterior calcaneal extension facet, which can be associated with talar beaking.

Correlation between the accessory anterolateral talar facet, bone marrow edema, and tarsal coalitions.

The purposes of this study was to determine the prevalence of the accessory anterolateral talar facet (AALTF); to evaluate the relationship between AALTF, focal abutting bone marrow edema (FABME), and sinus tarsi edema; and to study the prevalence of tarsal coalitions in patients with the AALTF utilizing ankle MR images. 5-T ankle MR images were reviewed for the presence of AALTF, FABME, sinus tarsi edema, tarsal coalition, and location and type of coalition (cartilaginous, fibrous, and osseous). Multivariate analysis was performed to examine the correlation between AALTF and the other variables. Three hundred ninety-one consecutive patients were included (age range 5-86 years; mean age 45 years). An AALTF was present in 3.6% (14/391) of patients. The AALTF prevalence was 2% in women and 6.6% in men. There was a significantly association between AALTF and FABME (9/14, p < 0.05), sinus tarsi edema (13/14, p < 0.05), and tarsal coalition (4/14, p < 0.05). AALTF is relatively often detected on MRI of the ankle and significantly associated with BME, sinus tarsi edema, and subtalar coalition. Patients with a tarsal coalition should be evaluated for the concurrent presence of an AALTF.

腓骨筋痙性扁平足に対しaccessory anterolateral talar facet切除術が著効した1例

腓骨筋痙性扁平足に対しaccessory anterolateral talar facet切除術が著効した1例

Accessory anterolateral talar facet associated with tarsal coalition: prevalence and cross-sectional characterization.

The accessory anterolateral talar facet (AALTF) is a developmental entity described as a potential cause for rigid, painful flat foot. This study evaluates the possible association between the AALTF and other flat foot etiologies, specifically different types of tarsal coalitions. We evaluated patients with tarsal coalition or sinus tarsi syndrome for an AALTF on CT and MRI. Exclusion criteria included acute ankle trauma, recent surgery, motion or metal artifacts. We evaluated the AALTF length and height, and the lateral talocalcaneal structures for associated findings. The presence of calcaneonavicular (CNC), intra-articular middle facet talocalcaneal (MFTCC), posterior facet talocalcaneal (PFTCC), extra-articular posteromedial talocalcaneal (EATCC) and other rare coalitions were also evaluated. One hundred eighty-seven patients were included (age range 14-91years; mean ± SD; 50 ± 17years). The AALTF prevalence in the study population was 31.55% (59/187), 40.91% in men, and 23.23% in women. The AALTF average length was 4.5 ± 1.1mm, and average height was 8.9 ± 3.4mm. The AALTF was found to be significantly associated with lateral talocalcaneal osseous changes such as cortical thickening and cystic changes (34/59 and 24/59 respectively, P < 0.01). The AALTF was also found to be significantly associated with sinus tarsi edema on MRI (45/52, P < 0.05). The AALTF was also significantly associated with EATCC (19/59, P < 0.01) and MFTCC (7/59, P < 0.05). No significant association was found with CNC, PFTCC or other rare coalitions. The AALTF is common and significantly associated with some tarsal coalitions, specifically EATCC and MFTCC. When an AALTF or coalition is identified, special attention should be made to evaluate for other associated pathologies, as this could potentially affect management.

Prevalence of AALTF and relevant associated MR findings in persons with and without sinus tarsi pain

Category: Ankle Introduction/Purpose: Sinus tarsi pain is very common, however, etiology of this condition has not been well understood. The purpose of this study was to evaluate differences of MRI findings between persons with and without sinus tarsi pain and to investigate the relationships of sinus tarsi pain and accessory anterolateral talar facet (AALTF). Methods: We reviewed MR images of 120 ankles with sinus tarsi pain in 115 consecutively registered patients. And age- and sex-matched MR images of 120 ankles without pain were also reviewed. We compared the presence of AALTF, calcaneal cyst (CC), bone marrow edema (BME), sinus tarsi fat obliteration (STFO) at the Gissane angle, and coalition between persons with and without sinus tarsi pain. We also compared Gissane angle, talar infero-lateral surface angle (TILSA), and calcaneal cortical thickness (CCT). Of persons with sinus tarsi pain, we compared these parameters between persons with and without AALTF. Results: AALTF was present in 61 ankles (50.8%) with sinus tarsi pain and 34 ankles (28.3%) without sinus tarsi pain (P&lt;0.001). BME (P=0.001) and STFO (P=0.009) were significantly more frequent in persons with sinus tarsi pain. Presences of CC (P=0.108) and coalition (P=0.605) were not different. The Gissane angle was significantly smaller in persons with sinus tarsi pain than in persons without sinus tarsi pain (P&lt;0.001) and TILSA (P=0.032), and CCT (P&lt;0.001) were significantly larger in persons without sinus tarsi pain (Table 1). Of persons with sinus tarsi pain, BME was significantly more frequent in persons with AALTF and TILSA (P=0.032) and CCT were significantly larger in persons with AALTF (Table 2). Conclusion: The MRI findings of patients with sinus tarsi pain showed higher prevalence of AALTF, BME, and STFO. The AALTF may be associated with the MRI findings of talar and calcaneal BME.

Accessory Talar Facet Impingement due to Accessory Anterolateral Talar Facet Misdiagnosed as Sinus Tarsi Syndrome

Accessory Talar Facet Impingement due to Accessory Anterolateral Talar Facet Misdiagnosed as Sinus Tarsi Syndrome

Accessory Anterolateral Talar Facet in Populations With and Without Symptoms: Prevalence and Relevant Associated Ankle MRI Findings

The purpose of this study was to determine the prevalence of and relevant findings associated with the accessory anterolateral talar facet, which may have a role in talocalcaneal impingement and sinus tarsi syndrome, on ankle MR images of persons with and those without symptoms. In this case-control study, three observers independently reviewed 1.5-T or 3-T MR images of 110 ankles with symptoms in 100 consecutively registered patients (age range, 16-79 years; mean, 41.5 years) and limited 1.5-T MR images of 104 age-, sex-, and side-matched ankles in 104 volunteers without symptoms for the presence of an accessory anterolateral talar facet, calcaneal cortical thickness, subjacent talar or calcaneal cystic and bone marrow edema-like changes at the angle of Gissane, and sinus tarsi fat obliteration. An accessory anterolateral talar facet was present in 36 (32.7%) ankles with symptoms versus 27 (26.0%) symptom-free ankles (p = 0.297). Interobserver agreement was almost perfect (κ = 0.851; 95% CI, 0.772-0.929) for the detection of accessory anterolateral talar facet and substantial for the detection of sinus tarsi fat obliteration (κ = 0.671; 95% CI, 0.427-0.915). The angle of Gissane was significantly smaller in persons with an accessory anterolateral talar facet, either with or without symptoms (p < 0.0001). Subjacent talar (p = 0.003) and calcaneal (p = 0.033) bone marrow edema-like change and sinus tarsi fat obliteration (p = 0.034) were significantly more frequent in persons with accessory anterolateral talar facet, but chronic reactive osseous changes at the angle of Gissane were not (p > 0.05). The higher prevalence of the MRI finding of an accessory anterolateral talar facet in ankles with symptoms is not statistically significant. This facet may be associated with subjacent talar bone marrow edema-like change on MR images of individuals with and those without symptoms and with sinus tarsi fat obliteration in individuals with symptoms.

Arthroscopic Debridement of Pediatric Accessory Anterolateral Talar Facet Causing Impingement

Symptomatic subfibular and/or lateral talocalcaneal impingement in pediatric patients may result from an accessory anterolateral talar facet (AALTF). This impingement may cause pain and disability and may limit athletic performance in high-level athletes. We report the case of a 12-year-old female competitive gymnast who had refractory, lateral-sided right ankle pain for 4 months and underwent right ankle arthroscopic resection of the AALTF causing impingement. Standard medial and anterolateral portals with the addition of an accessory anterolateral-distal portal were used in conjunction with a 30° 2.7-mm-diameter arthroscope. The AALTF was resected with a combination of a shaver and a motorized rasp. Intraoperative fluoroscopy was used to verify successful debridement of the bony facet. This case illustrates that arthroscopic debridement is a technique to treat subfibular and/or talocalcaneal impingement associated with an AALTF.

Peroneal spastic flatfoot in adolescents with accessory talar facet impingement: a preliminary report.

This study analyzed imaging, arthroscopic findings, and treatment responses for peroneal spastic flatfoot (PSFF) caused by talocalcaneal impingement at the accessory anterolateral talar facet (AALTF) (accessory talar facet impingement) in 13 adolescents without histories of trauma and tarsal coalition. The AALTF was determined with computed tomography and MRI. Focal abutting bone marrow edema (FABME) on MRI around the AALTF was confirmed. In seven patients who underwent AALTF resection, subtalar arthroscopy was performed. All experienced alleviation PSFF after treatment; reduction in FABME was observed. AALTF resection alone is beneficial for PSFF caused by accessory talar facet impingement when peroneal spasms are restored by an injection of local anesthesia.

An anatomic study of the accessory anterolateral talar facet.

A small accessory facet with articular surface morphology is occasionally seen on the talus, bordering on the lateral end of the sinus tarsi. This facet has been named the accessory anterolateral talar facet. However, few anatomical studies have addressed this facet. Here we present the precise morphology of accessory anterolateral talar facet with emphasis on anatomical correlation between the presence of this facet and the angle of the infero-lateral surface of the talus (talar infero-lateral surface - TILS angle). A total of 22 (11 male, 11 female) adult cadavers with no known pathological conditions in the talocalcaneal joints were examined during educational dissection at Nagoya City University Medical School in 2013. After exclusion of 1 joint due to the poor condition of the talus, 43 talus (22 right, 21 left) were analysed. We judged the presence of the accessory anterolateral talar facet and measured TILS angle. We performed statistical analysis on the point of laterality, gender difference and the difference in the TILS angles in tali with or without the accessory anterolateral talar facets. An accessory anterolateral talar facet was identified in 11 (26%) of the 43 specimens. Of the 21 cadavers with paired talar specimens, 5 displayed the facet bilaterally. There was no sex difference and no significant laterality, however we found that TILS angle was significantly larger in accessory anterolateral talar facet positive samples than in negative ones.

Anatomical characteristics of the accessory antero-lateral talar facet.

We examined the anatomical features of the accessory antero-lateral talar facet (AALTF) in adults. The sample comprised 44 feet (male: 10 cadavers and 20 feet; female: 12 cadavers and 24 feet) obtained from 22 cadavers used for systemic autopsy. The mean age was 86.5 years. The talus and calcaneus were obtained from the autopsy cadavers, and the soft tissue was surgically removed from the bone. The talus and calcaneus were then separated and their anatomical features were observed. The AALTF was identified in 11 of 44 (25 %) feet. The presence or absence of the AALTF and calcaneal facet opposing the AALTF were classified into four groups: (1) joint type with articular cartilage on both the talus and calcaneus; (2) talar type with articular cartilage on the talus only; (3) calcaneal type with articular cartilage on the calcaneus only; and (4) non-joint type with no articular cartilage on either the talus or calcaneus. When the AALTF is present, the talus comes into contact with the calcaneus, and thus even slight changes around the talus and calcaneus can easily cause impingement.

Accessory talar facet impingement in pathologic conditions of the peritalar region in adults.

Associations between accessory anterolateral talar facet (AALTF) and sinus tarsi pain in adults have not been reported. This study aimed to investigate the clinical and imaging characteristics of pathologic conditions of the peritalar region in adults with painful accessory talar facet impingement (ATFI). We included 31 patients (aged 19-75 years) with persistent sinus tarsi pain who underwent surgery and had pathologic conditions of the peritalar region, including adult acquired flatfoot deformity (AAFD; 18 patients), ankle osteoarthritis (8 patients), and ankle instability (5 patients). Continuity between the articular surface of the posterior facet of the talus and AALTF was identified on preoperative computed tomography and magnetic resonance imaging (MRI) of the cartilage. In addition, focal abutting bone marrow edema (FABME) of the talus and calcaneal neck around the AALTF on short TI inversion recovery sequence MRI was confirmed. Subtalar arthroscopy was used to evaluate the AALTF surface characteristics. Pre- and postoperative objective scores were compared. Eight pre- and postoperative radiographic parameters were compared to confirm the effect of foot alignment changes after reconstructions on sinus tarsi pain with ATFI. Pre- and postoperative changes in FABME were compared with 17.1 (7-60) months of follow-up. Subjects underwent accessory facet resection with balancing reconstruction. Arthroscopically, 66% of patients showed a focal defect on the AALTF cartilage surface, and 83% showed attenuation of the posterior capsular ligament. All x-ray parameters in AAFD patients showed significant improvement postoperatively (P < .001). Mean objective scores improved from 54.0 preoperatively to 91.0 postoperatively (P < .001). Sinus tarsi pain and FABME were absent in all cases at the final follow-up. AALTF represents a new etiology of subsequent painful intra-articular talocalcaneal impingement. When addressing sinus tarsi pain, it is important to detect the signs of AALTF on MRI of the cartilage and accompanying FABME. Level IV, retrospective case series.

Accessory Anterolateral Facet of the Pediatric Talus

The accessory anterolateral talar facet may be associated with talocalcaneal impingement in the painful flatfoot. We performed an anatomic study to identify this accessory facet and its associated osteologic features. Within the Hamann-Todd Human Osteological Collection, seventy-nine paired tali and calcanei were identified among forty-three skeletons from individuals who had had an average age of 13.4 years at the time of death. Each specimen was surveyed for an accessory anterolateral talar facet, a calcaneal neck anterior extension facet, a dorsal talar beak, and the talocalcaneal facet pattern. Measurements included the angle of Gissane, posterior facet inclination, calcaneal neck length, posterior facet length, overall calcaneal and talar lengths, and accessory facet dimensions. Lateral radiographs of specimens with accessory facets were made in neutral and everted subtalar alignment. An accessory anterolateral talar facet was identified in twenty-seven (34%) of the seventy-nine specimens and was large in two (2.5%). Of the thirty-six skeletons with paired specimens, fifteen had an accessory facet and, of those, ten had the finding bilaterally. Degenerative changes or tarsal coalitions were not observed. Lateral radiographs demonstrated that subtalar eversion obscured observation of the facet. The accessory facet was associated with greater mean age (16.7 compared with 10.9 years; p < 0.0001), male sex (63% compared with 21%; p = 0.011), and a smaller mean angle of Gissane (116.2 degrees compared with 122.2 degrees; p = 0.018). Relative accessory facet volume was positively correlated with increased relative calcaneal posterior facet length (r = 0.53, p = 0.029). The accessory facet was significantly associated with dorsal talar beaking (29% compared with 4%; p = 0.028). An accessory anterolateral talar facet was found in 34% of the specimens in a pediatric osteologic collection. The facet was associated with male sex, a smaller angle of Gissane, and dorsal talar beaking.