Sinus Tarsi

The sinus tarsi is a cone-shaped area bounded by the talus superiorly and the calcaneus inferiorly, located at the anterolateral aspect of the subtalar joint. Within the sinus tarsi are the interosseous talocalcaneal ligament (Fig. 39); the cervical ligament (Fig. 40); nerve branches from the deep peroneal nerve [86]; arterial branches arising from the anterior lateral malleolar artery and the lateral tarsal artery [87]; a venous plexus; and the medial, intermediate, and lateral roots of the inferior extensor retinaculum (Fig. 41) [53]. The ligaments of the sinus tarsi contribute to stability of the talocalcaneal joint [88]. Sinus tarsi syndrome refers to persistent pain at the anterolateral aspect of the ankle, often with a sensation of hindfoot instability [89]. This most commonly occurs after ankle inversion injury with injury to the ligaments within the sinus tarsi (Fig. 42) [89]. Alternate etiologies have been hypothesized as well, including ganglia in the sinus tarsi (Fig. 43) [90], posttraumatic venous fibrosis causing disturbance of venous outflow [87], or disorders of nociception and

Sinus Tarsi Syndrooma
Fig. 46. Normal plantar (A) and dorsal (B) components of the Lisfranc ligament (arrows).
Sinus Tarsi Syndrom
Fig. 47. Oblique coronal STIR and FSE images demonstrate partial tear of the Lisfranc ligament (arrows). (Courtesy of Department of MRI, Hospital for Special Surgery, New York, NY.)

proprioception of the nerve endings in the sinus tarsi [91]. Various treatment methods have been used, including arthroscopic subtalar joint synovectomy [89], denervation of the sinus tarsi [92], or corticosteroid injection [93], all reporting good results.

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