Tarsal Coalition
Tarsal coalition is the abnormal connection that develops between two bones in the foot. This abnormal connection can be composed of bone, cartilage, or fibrous tissue. The symptoms of this tarsal coalition stems from limited motion at the site, oftening resulting in pain. While most patients are born with this condition, the symptoms do not exhibit until bones begin to mature around age 9 to 16. Other causes of coalition include infection, arthritis, or a previous injury to the area. General symptoms include pain, fatigue in the legs, muscle spasm in the legs and feet, walking with a limp, and stiffness in the foot and ankle.
Diagnosis:
Obtaining information regarding the duration, and development of the symptoms, as well as a thorough examination of the foot and ankle is important. Limited range of motion at different joints can indicate the location of the coalition. In addition to a foot exam, X-rays and other advanced imaging such as CT scans can be ordered.
Treatment:
Conservative treatment involves symptom relief through the following:
Tarsal coalition is the abnormal connection that develops between two bones in the foot. This abnormal connection can be composed of bone, cartilage, or fibrous tissue. The symptoms of this tarsal coalition stems from limited motion at the site, oftening resulting in pain. While most patients are born with this condition, the symptoms do not exhibit until bones begin to mature around age 9 to 16. Other causes of coalition include infection, arthritis, or a previous injury to the area. General symptoms include pain, fatigue in the legs, muscle spasm in the legs and feet, walking with a limp, and stiffness in the foot and ankle.
Diagnosis:
Obtaining information regarding the duration, and development of the symptoms, as well as a thorough examination of the foot and ankle is important. Limited range of motion at different joints can indicate the location of the coalition. In addition to a foot exam, X-rays and other advanced imaging such as CT scans can be ordered.
Treatment:
Conservative treatment involves symptom relief through the following:
- Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation.
- Physical therapy. Physical therapy may include massage, range-of-motion exercises and ultrasound therapy.
- Steroid injections. An injection of cortisone into the affected joint reduces the inflammation and pain. Sometimes more than one injection is necessary.
- Orthotic devices. Custom orthotic devices can be beneficial in distributing weight away from the joint, limiting motion at the joint and relieving pain.
- Immobilization. Sometimes the foot is immobilized to give the affected area a rest. The foot is placed in a cast or cast boot, and crutches are used to avoid placing weight on the foot.
- Injection of an anesthetic agent. Injection of an anesthetic into the leg may be used to relax spasms and is often performed prior to immobilization.