American Journal of Roentgenology, Vol 154, 559-562, Copyright © 1990 by American Roentgen Ray Society
Subtalar arthrosis: evaluation with CT
DK Smith, LA Gilula and WG Totty
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110.
The surgical implantation of a Silastic wedge into the lateral subtalar
joint (subtalar arthrosis) is designed to restrict the osseous malalignment
associated with a flexible or neurogenic flatfoot deformity. We used CT to
examine patients who had persistent pain after a subtalar arthrosis and
retrospectively reviewed our experience with CT scans of 13 subtalar
implants (seven patients) during a 3.5-year period. The CT scans of four
asymptomatic subtalar implants showed each implant in the expected position
and orientation, and the findings were considered normal. Conversely, the
findings on CT scans of all nine painful implants (seven patients) were
interpreted as abnormal. The scans showed oblique orientation of four
implants (44%), loosening of three implants (33%), extruded methyl
methacrylate in the subtalar joint in two implants (22%), and abnormal
calcaneal recession in two implants (22%). Five of the nine painful
implants were revised with improvement or resolution of symptoms. Our
experience suggests that CT scanning of the subtalar joint can show the
position and orientation of a subtalar implant and identify causes of
persistent pain after a subtalar arthrosis.
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