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Posterior talar projection (Beak)

Discussion in 'General Issues and Discussion Forum' started by David Smith, Jan 30, 2018.

  1. David Smith

    David Smith Well-Known Member


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    Hello all

    I wonder if you could say what you think about these ankle X rays, lateral and Mortice view

    I think there is an enlarged posterior Talus projection or beak and the Kagel's fat pad is disrupted in the upper portion.

    Ankle OA and Gout - Had key hole surgery on ankle 2010 - arthroscopy

    Reports - Lot of pain in left ankle - been painful for long time perhaps 7+ years when he was dancing and felt that something snapped - low ache all day long, every day. Main Pain in medial ankle and some in plantar LMA.

    Pain on palpation of trac of Post tib and insertion, pain on pressure to anterior talus (pushing it backwards). -

    Dx PTTD - Mild PFasciitis at origin

    Request X rays query talar chondropathy or osteophytes


    Cheers Dave
     

    Attached Files:

  2. efuller

    efuller MVP

    A normal variation is an enlarged posterior process of the talus. There can also be an accessory bone in that location. (the name is not coming to me right now Os vesalium?) These can be come problematic in sports with extreme plantar flexion e.g. ballet dancers on pointe. My advice is to treat the symptoms, not the x-ray.
     
  3. David Smith

    David Smith Well-Known Member

    Thanks Eric
     
  4. Dieter Fellner

    Dieter Fellner Well-Known Member

    os trigonum or Stieda's process as is the case here. As Eric points out can be problematic, often in dancers, when a lot of time is spent with ankle in extreme plantar flexion, but also sometimes seen as a cause of rearfoot pain in other patient. Google os trigonum syndrome.
     
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