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Ligaments of the Transverse Tarsal Joint Complex: MRI–Anatomic Correlation in Cadavers

¹ Serviço de Radiologia, Faculdade de Medicina da Universidade do Porto, Hospital São João, Alameda Professor Hernâni Monteiro, 4200-451 Porto, Portugal.
² Department of Radiology, University of California, San Diego, VA San Diego Healthcare System, San Diego, CA.
³ Orthopaedic Department, Hospital Geral de Santo António, Porto, Portugal.

OBJECTIVE. The objective of our study was to clarify the detailed anatomy of the transverse tarsal joint ligamentous complex and evaluate the diagnostic capability of MRI in the assessment of the tarsal joint complex with detailed anatomic correlation in cadavers.

MATERIALS AND METHODS. Ten fresh cadaveric feet were studied with high-spatial-resolution MRI before and after intraarticular injection of a gadopentetate dimeglumine solution. MR images were evaluated by two readers, with an emphasis on the visibility of ligamentous structures and their appearance and signal intensity. Readers also measured the dimensions (length, width, and thickness) of the different components of the spring ligament complex, bifurcate ligament, and plantar calcaneocuboid ligaments. For anatomic analysis, nine cadaveric specimens were sectioned in 3-mm-thick slices in the same planes used for MRI. One additional foot specimen was used for dissection.

RESULTS. In all 10 cadaveric specimens, we were able to identify the various ligamentous elements, their different configurations, imaging characteristics, and contributions to the overall stability of the transverse tarsal joint complex.

CONCLUSION. By clearly defining the normal ligaments that contribute to the stability of the calcaneocuboid joint, MRI allows a more precise and correct diagnosis of the etiology of the calcaneocuboid instability, perhaps permitting a more specific surgical management. MRI also allows a better understanding of the normal imaging anatomy of the different components of the ligamentous structures of the talocalcaneonavicular joint, particularly of the spring ligament complex.

Keywords: anatomy • calcaneocuboid joint • midfoot ligaments • MRI • musculoskeletal imaging • sports medicine • talocalcaneonavicular joint

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