Frequency of Os trigonum and Stieda process, determination of its relation with posterior ankle pain and tendinopathy by ankle MRI
Öz
ABSTRACT
Aim: To investigate the frequency of Os trigonum and Stieda process and the relationship of Os trigonum with other pathologies detected by magnetic resonance imaging (MRI) in patients with posterior ankle pain.
Methods: This was a retrospective study conducted by re-examining MRI images obtained between January 2017 and May 2023. The study included 482 patients (496 ankles) who underwent ankle MRI for diagnostic purposes due to posterior or posterolateral ankle pain. MRI images were re-examined for the following parameters: fractures, contusion, tendinosis, ligament injury, arthritis, effusion, presence of Stieda process, posterior ankle bursa impingement, Os trigonum, retrocalcaneal bursitis, ganglion cyst, widespread osteophytes, accessory navicular bone, presence and grade of osteochondritis dissecans, and presence and type of Achilles tendon pathology.
Results: The mean age of the participants was 41.96 ± 15.89 (7–83 years), and 51.04% (n = 246) were male. Os trigonum was detected in 17 patients (3.43 %), and none of the cases were bilateral. The likelihood of Os trigonum was significantly higher in males (p = 0.016, OR: 4.725, 95% CI: 1.341 - 16.655). Stieda process was detected in 186 patients (37.5 %). The accessory navicular bone was detected in 8 (1.61%). The percentage of patients with pathological metatarsal fractures was significantly higher in patients with Os trigonum (p = 0.034). The frequency of Stieda process was significantly lower in patients with Os trigonum (p = 0.013, OR: 0.099, 95% CI: 0.013 - 0.755). There were significantly fewer cases of talotibial effusion in the Os trigonum group (p = 0.030).
Conclusion: While Os trigonum appears to be significantly more frequent among males, it is less frequent in the presence of the Stieda process and talotibial effusion.
Anahtar Kelimeler
Magnetic resonance imaging Os trigonum Posterior ankle pain Talotibial effusion
Kaynakça
- Berndt, A. L., Harty, M. (1959). Transchondral fractures (osteochondritis dissecans) of the talus. J Bone Joint Surg Am, 41-a, 988-1020.
- Bureau, N. J., Cardinal, E., Hobden, R., Aubin, B. (2000). Posterior ankle impingement syndrome: MR imaging findings in seven patients. Radiology, 215(2), 497-503. doi:10.1148/radiology.215.2.r00ma01497
- Burman, M., Lapidus, P. W. (1931). The functional disturbances caused by the inconstant bones and sesamoids of the foot. Arch Surg, 22(6), 936-975.
- Corte-Real, N. M., Moreira, R. M., Guerra-Pinto, F. (2012). Arthroscopic treatment of tenosynovitis of the flexor hallucis longus tendon. Foot Ankle Int, 33(12), 1108-1012. doi:10.3113/fai.2012.1108
- Coskun, N., Yuksel, M., Cevener, M., Arican, R. Y., Ozdemir, H., Bircan, O., Sindel, T., Ilgi, S., Sindel, M. (2009). Incidence of accessory ossicles and sesamoid bones in the feet: a radiographic study of the Turkish subjects. Surg Radiol Anat, 31(1), 19-24. doi:10.1007/s00276-008-0383-9
- Derin Cicek, E., Bankaoglu, M. (2020). Prevalence of Elongated Posterior Talar Process (Stieda Process) Detected by Radiography. Int J Morphol, 38(4), 894-898.
- Guo, S., Yan, Y. Y., Lee, S. S. Y., Tan, T. J. (2019). Accessory ossicles of the foot-an imaging conundrum. Emerg Radiol, 26(4), 465-478. doi:10.1007/s10140-019-01688-x
- Kalbouneh, H. M., Alajoulin, O., Alsalem, M., Mansour, Y., Shawaqfeh, J., Altarawneh, T., Alhusni, D., Al-Muhtaseb, M. H. (2019). Incidence of symptomatic os trigonum among nonathletic patients with ankle sprain. Surg Radiol Anat, 41(12), 1433-1439. doi:10.1007/s00276-019-02354-0
- Karasick, D., Schweitzer, M. E. (1996). The os trigonum syndrome: imaging features. AJR Am J Roentgenol, 166(1), 125-129. doi:10.2214/ajr.166.1.8571860
- Kudaş, S., Dönmez, G., Işık, Ç., Çelebi, M., Çay, N., Bozkurt, M. (2016). Posterior ankle impingement syndrome in football players: Case series of 26 elite athletes. Acta Orthop Traumatol Turc, 50(6), 649-654. doi:10.1016/j.aott.2016.03.008
- Mann, R. W., Owsley, D. W. (1990). Os trigonum. Variation of a common accessory ossicle of the talus. J Am Podiatr Med Assoc, 80(10), 536-539. doi:10.7547/87507315-80-10-536
- Maquirriain, J. (2005). Posterior ankle impingement syndrome. J Am Acad Orthop Surg, 13(6), 365-371. doi:10.5435/00124635-200510000-00001
- Mc, D. A. (1955). The os trigonum. J Bone Joint Surg Br, 37-b(2), 257-265. doi:10.1302/0301-620x.37b2.257
- Mellado, J. M., Ramos, A., Salvadó, E., Camins, A., Danús, M., Saurí, A. (2003). Accessory ossicles and sesamoid bones of the ankle and foot: imaging findings, clinical significance and differential diagnosis. Eur Radiol, 13 Suppl 6, L164- L177. doi:10.1007/s00330-003-2011-8
- Nault, M. L., Kocher, M. S., Micheli, L. J. (2014). Os trigonum syndrome. J Am Acad Orthop Surg, 22(9), 545-553. doi:10.5435/jaaos-22-09-545
- Nwawka, O. K., Hayashi, D., Diaz, L. E., Goud, A. R., Arndt, W. F., 3rd, Roemer, F. W., Malguria, N., Guermazi, A. (2013). Sesamoids and accessory ossicles of the foot: anatomical variability and related pathology. Insights Imaging, 4(5), 581-593. doi:10.1007/s13244-013-0277-1
- Pesquer, L., Guillo, S., Meyer, P., Hauger, O. (2014). US in ankle impingement syndrome. J Ultrasound, 17(2), 89-97. doi:10.1007/s40477-013-0054-5
- Robinson, P., White, L. M. (2002). Soft-tissue and osseous impingement syndromes of the ankle: role of imaging in diagnosis and management. Radiographics, 22(6), 1457-1469; discussion 70-1. doi:10.1148/rg.226025034
- Stieda, L. (1869). Ueber secundäre Fusswurzelknochen. Arch Anat Physiol., 36, 108-111.
- Tokgöz, M. A., Ataoğlu, M. B., Ergişi, Y., Bozkurt, H. H., Kanatlı, U. (2020). Is there any effect of presence and size of os trigonum on flexor hallucis longus tendon lesions? Foot Ankle Surg, 26(4), 469-472. doi:10.1016/j.fas.2019.05.018
- Uygur, E., Aktaş, B., Öz, T. T., Erinç, S., Koç, M. (2016). Prevalence of accessory bones of the foot in Turkish patients. JAREM, 6(3), 147-151. doi:10.5152/jarem.2016.1085
- Wong, G. N. L., Tan, T. J. (2016). MR imaging as a problem solving tool in posterior ankle pain: A review. Eur J Radiol, 85(12), 2238-2256. doi:10.1016/j.ejrad.2016.10.016
- Yasui, Y., Hannon, C. P., Hurley, E., Kennedy, J. G. (2016). Posterior ankle impingement syndrome: A systematic four-stage approach. World J Orthop, 7(10), 657-663. doi:10.5312/wjo.v7.i10.657
- Zwiers, R., Baltes, T. P. A., Opdam, K. T. M., Wiegerinck, J. I., van Dijk, C. N. (2018). Prevalence of Os Trigonum on CT Imaging. Foot Ankle Int, 39(3), 338-342. doi:10.1177/1071100717740937
Os trigonum ve Stieda prosesinin görülme sıklığı, ayak bileği MRG ile posterior ayak bileği ağrısı ve tendinopati ilişkisinin belirlenmesi
Öz
ÖZET
Amaç: posterior ayak bileği ağrısı olan hastalarda Os trigonumun görülme sıklığını ve manyetik rezonans görüntüleme (MRG) ile saptanan diğer patolojiler ile ilişkisini araştırmak.
Yöntemler: Ocak 2017 ile Mayıs 2023 tarihleri arasında elde edilen MRG görüntülerinin yeniden incelenmesiyle yapılan retrospektif bir çalışmadır. Çalışmaya posterior veya posterolateral ayak bileği ağrısı nedeniyle tanısal amaçlı ayak bileği MRG yapılan 482 hasta (496 ayak bileği) dahil edildi. MRG görüntüleri şu parametreler açısından yeniden incelendi: kırıklar, kontüzyon, tendinozis, bağ yaralanması, artrit, efüzyon, Stieda prosesi varlığı, posterior ayak bileği bursa sıkışması, Os trigonum, retrokalkaneal bursit, ganglion. kist, yaygın osteofitler, aksesuar naviküler kemik, osteokondritis dissekanların varlığı ve derecesi ve Aşil tendon patolojisinin varlığı ve tipi.
Bulgular: Katılımcıların yaş ortalaması 41,96 ± 15,89 (7–83 yaş) ve %51,04'ü (n=246) erkekti. Os trigonum 17 hastada (%3.43) saptandı ve hiçbir olgu bilateral değildi. Os trigonum olasılığı erkeklerde anlamlı olarak daha yüksekti (p = 0,016, OR: 4,725, %95 GA: 1,341 - 16,655). Stieda prosesi 186 hastada (%37.5) saptandı. Aksesuar navikular kemik 8 (%1,61) hastada tespit edildi. Patolojik metatarsal kırığı olan hasta yüzdesi Os trigonumlu hastalarda anlamlı olarak daha yüksekti (p=0.034). Os trigonumlu hastalarda Stieda prosesi sıklığı anlamlı olarak daha düşüktü (p = 0,013, OR: 0,099, %95 GA: 0,013 - 0,755). Os trigonum grubunda önemli ölçüde daha az talotibial efüzyon vakası vardı (p = 0.030).
Sonuç: Os trigonum erkeklerde anlamlı olarak daha sık görülürken, Stieda prosesi ve talotibial efüzyon varlığında daha az sıklıkta görülmektedir.
Anahtar Kelimeler
Manyetik rezonans görüntüleme Os trigonum Posterior ayak bileği ağrısı Talotibial efüzyon
Kaynakça
- Berndt, A. L., Harty, M. (1959). Transchondral fractures (osteochondritis dissecans) of the talus. J Bone Joint Surg Am, 41-a, 988-1020.
- Bureau, N. J., Cardinal, E., Hobden, R., Aubin, B. (2000). Posterior ankle impingement syndrome: MR imaging findings in seven patients. Radiology, 215(2), 497-503. doi:10.1148/radiology.215.2.r00ma01497
- Burman, M., Lapidus, P. W. (1931). The functional disturbances caused by the inconstant bones and sesamoids of the foot. Arch Surg, 22(6), 936-975.
- Corte-Real, N. M., Moreira, R. M., Guerra-Pinto, F. (2012). Arthroscopic treatment of tenosynovitis of the flexor hallucis longus tendon. Foot Ankle Int, 33(12), 1108-1012. doi:10.3113/fai.2012.1108
- Coskun, N., Yuksel, M., Cevener, M., Arican, R. Y., Ozdemir, H., Bircan, O., Sindel, T., Ilgi, S., Sindel, M. (2009). Incidence of accessory ossicles and sesamoid bones in the feet: a radiographic study of the Turkish subjects. Surg Radiol Anat, 31(1), 19-24. doi:10.1007/s00276-008-0383-9
- Derin Cicek, E., Bankaoglu, M. (2020). Prevalence of Elongated Posterior Talar Process (Stieda Process) Detected by Radiography. Int J Morphol, 38(4), 894-898.
- Guo, S., Yan, Y. Y., Lee, S. S. Y., Tan, T. J. (2019). Accessory ossicles of the foot-an imaging conundrum. Emerg Radiol, 26(4), 465-478. doi:10.1007/s10140-019-01688-x
- Kalbouneh, H. M., Alajoulin, O., Alsalem, M., Mansour, Y., Shawaqfeh, J., Altarawneh, T., Alhusni, D., Al-Muhtaseb, M. H. (2019). Incidence of symptomatic os trigonum among nonathletic patients with ankle sprain. Surg Radiol Anat, 41(12), 1433-1439. doi:10.1007/s00276-019-02354-0
- Karasick, D., Schweitzer, M. E. (1996). The os trigonum syndrome: imaging features. AJR Am J Roentgenol, 166(1), 125-129. doi:10.2214/ajr.166.1.8571860
- Kudaş, S., Dönmez, G., Işık, Ç., Çelebi, M., Çay, N., Bozkurt, M. (2016). Posterior ankle impingement syndrome in football players: Case series of 26 elite athletes. Acta Orthop Traumatol Turc, 50(6), 649-654. doi:10.1016/j.aott.2016.03.008
- Mann, R. W., Owsley, D. W. (1990). Os trigonum. Variation of a common accessory ossicle of the talus. J Am Podiatr Med Assoc, 80(10), 536-539. doi:10.7547/87507315-80-10-536
- Maquirriain, J. (2005). Posterior ankle impingement syndrome. J Am Acad Orthop Surg, 13(6), 365-371. doi:10.5435/00124635-200510000-00001
- Mc, D. A. (1955). The os trigonum. J Bone Joint Surg Br, 37-b(2), 257-265. doi:10.1302/0301-620x.37b2.257
- Mellado, J. M., Ramos, A., Salvadó, E., Camins, A., Danús, M., Saurí, A. (2003). Accessory ossicles and sesamoid bones of the ankle and foot: imaging findings, clinical significance and differential diagnosis. Eur Radiol, 13 Suppl 6, L164- L177. doi:10.1007/s00330-003-2011-8
- Nault, M. L., Kocher, M. S., Micheli, L. J. (2014). Os trigonum syndrome. J Am Acad Orthop Surg, 22(9), 545-553. doi:10.5435/jaaos-22-09-545
- Nwawka, O. K., Hayashi, D., Diaz, L. E., Goud, A. R., Arndt, W. F., 3rd, Roemer, F. W., Malguria, N., Guermazi, A. (2013). Sesamoids and accessory ossicles of the foot: anatomical variability and related pathology. Insights Imaging, 4(5), 581-593. doi:10.1007/s13244-013-0277-1
- Pesquer, L., Guillo, S., Meyer, P., Hauger, O. (2014). US in ankle impingement syndrome. J Ultrasound, 17(2), 89-97. doi:10.1007/s40477-013-0054-5
- Robinson, P., White, L. M. (2002). Soft-tissue and osseous impingement syndromes of the ankle: role of imaging in diagnosis and management. Radiographics, 22(6), 1457-1469; discussion 70-1. doi:10.1148/rg.226025034
- Stieda, L. (1869). Ueber secundäre Fusswurzelknochen. Arch Anat Physiol., 36, 108-111.
- Tokgöz, M. A., Ataoğlu, M. B., Ergişi, Y., Bozkurt, H. H., Kanatlı, U. (2020). Is there any effect of presence and size of os trigonum on flexor hallucis longus tendon lesions? Foot Ankle Surg, 26(4), 469-472. doi:10.1016/j.fas.2019.05.018
- Uygur, E., Aktaş, B., Öz, T. T., Erinç, S., Koç, M. (2016). Prevalence of accessory bones of the foot in Turkish patients. JAREM, 6(3), 147-151. doi:10.5152/jarem.2016.1085
- Wong, G. N. L., Tan, T. J. (2016). MR imaging as a problem solving tool in posterior ankle pain: A review. Eur J Radiol, 85(12), 2238-2256. doi:10.1016/j.ejrad.2016.10.016
- Yasui, Y., Hannon, C. P., Hurley, E., Kennedy, J. G. (2016). Posterior ankle impingement syndrome: A systematic four-stage approach. World J Orthop, 7(10), 657-663. doi:10.5312/wjo.v7.i10.657
- Zwiers, R., Baltes, T. P. A., Opdam, K. T. M., Wiegerinck, J. I., van Dijk, C. N. (2018). Prevalence of Os Trigonum on CT Imaging. Foot Ankle Int, 39(3), 338-342. doi:10.1177/1071100717740937
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri (Diğer) |
| Bölüm | Makaleler |
| Yazarlar | |
| Erken Görünüm Tarihi | 18 Eylül 2023 |
| Yayımlanma Tarihi | 30 Eylül 2023 |
| Gönderilme Tarihi | 16 Ağustos 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 6 Sayı: 2 |
