Abstract
Background: Accurate history and examination is often supported by radiological imaging and diagnostic injection to diagnose joint pathology. In the foot and ankle communications have previously been reported which may reduce the sensitivity of this technique.
Method: We analysed the findings of 389 arthrograms of the foot and ankle, identifying any joint communications noted on imaging. A single consultant radiologist using local anaesthetic and contrast performed all injections.
Results: Observed results were similar to those previously reported for joint communications, with 13.9% of cases showing a communication between the ankle and subtalar joints (10% reported incidence), and a 42.3% communication rate between the talonavicular and calcaneocuboid joints. We also identified previously unreported communications between the anterior subtalar and naviculocuneiform joints (8%), anterior subtalar and calcaneocuboid joints (9%) and the naviculocuneiform and tarsometatarsal joints (1.1%).
Conclusion: This study confirms the presence of multiple joint communications within the foot, and highlights the potential importance of arthrography in the diagnosis of foot and ankle pathology. These communications must be appreciated when considering joint fusion within the foot and ankle, especially where local anaesthetic injection has been used to aid diagnosis.
Correspondence should be addressed to A.H.N. Robinson, BOX 37, Department of Orthopaedics, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Trust, Hills Road, Cambridge. CB2 0QQ, England.
