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Sinus Tarsi Syndrome

 
ICD-9 Classification / Treatment
Etiology / Natural History Associated Injuries / DDx
Anatomy Complications
Clinical Evaluation Follow-up Care
Xray / Diagnositc Tests Review References

synonyms:sinus tarsi syndrome, STS

Sinus Tarsi Syndrome ICD-9

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Sinus Tarsi Syndrome Etiology / Epidemiology / Natural History

  •  Subtalar instability, subtalar joint synovitis and fibrotic tissue infiltration in the sinus tarsi.
  •  "Sinus tarsi syndrome" may be an inaccurate term that should be replaced with a specific diagnosis: interosseous ligament tears, arthrofibrosis, degenerative joint disease (FreyC, Foot Ankle Int 1999;20(3):185-91).

Sinus Tarsi Syndrome Anatomy

  •  Thought to involve injuries to the talocrural interosseous and cervical ligaments.
  •  Interosseous talocalcaneal ligament (ITCL) maintains apposition of the subtalar joint, and has stabilizing effects for the subtalar joint against drawer forces applied to the calcaneus from lateral to medial. Tochigi Y, Foot Ankle Int. 2004 Aug;25(8):588-96

Sinus Tarsi Syndrome Clinical Evaluation

  • Swelling and tenderness in the anterolateral ankle in the area of the sinus tarsi.
  • May be associated with pes planus. 
  • Pain over the sinus tarsi at the end range of ankle plantarflexion with foot supination

Sinus Tarsi Syndrome Xray / Diagnositc Tests

  • Ankle /  Foot xrays generally normal; evaluate for pes planus, subtalar arthritis 
  • Magnetic resonance imaging demonstrates subtalar joint chronic synovitis and/or fibrosis

Sinus Tarsi Syndrome Classification / Treatment

  • Conservative treatment = balance and proprioceptive training, muscle strengthening exercises, bracing, taping, and foot orthosis. Shoes with a straight last, a firm heel counter, and rigid midsole.
  • Subtalar joint arthroscopy with synovectomy: mean return to full activity was 4 months. The mean postoperative AOFAS Ankle-Hindfoot Scale score = 85 points. (Oloff LM, J Foot Ankle Surg. 2001 May-Jun;40(3):152)

Sinus Tarsi Syndrome Associated Injuries / Differential Diagnosis

  • Lateral ankle impingement syndrome
  • Peroneal tendon instability

Sinus Tarsi Syndrome Complications

    Sinus Tarsi Syndrome Follow-up Care

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    Sinus Tarsi Syndrome Review References


     

     

     

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