Tarsal coalition is an abnormal connection of foot bones, caused by genetics, fetal development, or other factors. Symptoms include foot stiffness, lack of mobility, and pain. Diagnosis involves X-rays, CT scans, and MRIs. Treatment may involve medications, orthotic devices, or surgery.
A tarsal coalition is an abnormal connection of the bones in the foot, where the bones fail to separate properly. The condition can occur in just one or both feet. It can be caused by genetic factors and be hereditary, or it can be a congenital condition, which occurs during fetal development and presents itself at birth. Previous injuries, infections, and arthritis are some less common causes.
Some of the tarsal bones in the foot include the calcaneus, also known as the heel bone; the navicular; the astragalus; and cuboid bones. Normal foot function is made possible by these bones working together properly, and problems occur when these bones are joined abnormally. The union of the calcaneus and talus results in a talocalcaneal coalition, while failure of the separation between the calcaneus and the navicular bones results in a type of coalition known as a calcaneonavicular tarsal coalition.
The abnormal connections between the tarsal bones are not limited to the bones themselves; there may also be improper connections between the cartilage that joins the bones of the foot. Although some people are born with the condition, many won’t develop problems until their late teens. In many cases, people don’t know they have this condition until they visit a doctor for what may seem like common foot ailments and are then diagnosed.
Some common tarsal coalition symptoms include foot stiffness, lack of mobility, and extreme pain. The main symptom of this condition is pain, especially while walking. Other symptoms may include legs that tire easily and twitch frequently. Additionally, people with the condition may appear to have flat feet.
If a doctor suspects that an individual has a tarsal coalition, the patient will typically be referred for diagnostic testing. Some tests commonly used to diagnose this condition include X-rays, a computed tomography (CT) scan, and a magnetic resonance imaging (MRI) test. MRIs can be especially helpful in making a diagnosis because they can help screen the soft tissue of the foot and bone and can reveal a problem with the cartilage.
Treatment of tarsal coalition may involve medications, orthotic devices, and surgery. Anti-inflammatory drugs can be used to reduce the pain caused by the condition, and steroid injections can also be given to relieve inflammation. Additionally, pain management can be attempted by using shoe inserts and other orthotic devices to support the foot during motion. In severe cases of this condition, surgery may be required.
Tarsal coalition surgery may be recommended if all other efforts fail to give the patient relief from the troubling symptoms. During this surgery, the surgeon will typically remove the abnormality that joins the bones or further fuse the joints. The overall aim of the surgery is to relieve discomfort and restore mobility and normal function to the foot. Symptoms, age, and level of daily activities may be factors considered before having this type of surgery. After completing an exam and making an official diagnosis, a doctor will be able to decide on the best method of treatment for an individual with a tarsal coalition.
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