Thesis

124 Part I Chapter 5 plain radiographs (Figure 2, red circle) [8]. Comparable results with plain radiographs is noted for the CN bar in CNC with excellent specificity of 100%, but limited sensitivity of (73%) [7]. Thus, normal radiographs do not exclude this type of TC. Figure 1. Sixteen-year-old female patient with exercise-induced pain in both feet (predominantly left side) subsequent to a trauma that occurred around 11 months prior to the initial imaging. Plain radiographs of the left foot: 45 degrees oblique (left panel) and lateral view (right panel) show an extension of the navicular bone to posterolateral, approximating the anterior process of the calcaneus (known as the reversed anteater nose sign) with irregularity and narrowing of the bony interface between calcaneus and navicular, as well as associated sclerosis. On the lateral view, note a (modest) anterior tubular elongation of the superior calcaneus which approaches the navicular bone (known as the classical anteater nose sign). Therefore, these plain radiographs depict a combination of the classical and reversed anteater nose sign, consistent with a non-osseous calcaneonavicular. Figure 2. Lateral plain radiographs demonstrating a C-sign (blue arrows), a C-shaped line formed by the outline of the talar dome and the inferior margin of the sustentaculum tali on lateral projections suggestive of TCC. SPECT/CT showing partially fused TCC (posterior facet) with increased uptake in the non-fused area, indicating the likely pain generator region. CT, computed tomography; TCC, talocalcaneal coalitions.

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