Calcaneal & Navicular bonesPosted by Pete R on 2/06/04 at 12:52 (143780)
I have arch and some heel pain but no morning pain. Have tried everything inc orthotics (9 pairs!) and ESWT. Nothing has worked or made condition better. Pain is worse on standing and after 20 mins walking.
My pod has examined my MRI and x rays and thinks I may have a 'connection' between my calcaneal and navicular bones which may be restricting normal motion and causing the pain. Quite what the 'connection' is I don't know, although my pod can't see me for some 2 weeeks to undertake another examination. No other pod's have picked up on this from looking at the MRI's.
Is this possible, what is the connection (bone), and how can it be put right?
Appreciate your advise so i can talk to my pod with some knowledge.
Re: Calcaneal & Navicular bonesDr. David S. Wander on 2/06/04 at 17:56 (143821)
The 'connection' your pod is referring to is called a tarsal coalition. It is an abnormal 'bride' connecting the two bones that is not supposed to exist. The gold standard for determining whether a coalition exists is a CT scan. So if there is any question, a CT scan should be ordered. If a coalition does exist, surgery is the only way to correct it, though there are conservative ways to treat it.
Re: Dr WanderPete R on 2/07/04 at 12:48 (143866)
I have bilateral problems. How successful is the surgery usually ?
Is the pain with this condition normally in the arch and occasionally the heel...........these are my symptoms particularly on standing and walkng for 20 to 30 mins ?
Why a CT scan, i thought MRI was the gold standard ?
Re: Dr WanderDr. David S. Wander on 2/08/04 at 10:54 (143930)
CT scan is the gold standard for tarsal coalitions, because no other study shows the bony architecture as well. MRI is the gold standard for soft tissue problems. Although MRI does show bone, a CT scan is best for determining tarsal coalitions. If you have already had an MRI, the coalition should be noted on those films. The pain can differ according to the type of coalition and other factors. Surgery is usually very successful if performed by someone with significant experience with this procedure.