Sinus Tarsi Syndrome
Original Editors - Merlin Roggeman
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Search Strategy[edit | edit source]
To search for information you can use databases such as PubMed, Web of Science, PEDro or Google Scholar. Use keywords as ‘sinus tarsi syndrome’ or ‘sinus tarsitis’. For specific information you can use ‘AND’ and add ‘physical therapy’, ‘characteristics’, ‘definition’, depending on what you search. Also choose articles from which the full text is available for free.
Definition/Description[edit | edit source]
The sinus tarsi syndrome is a foot pathology, mostly following after a traumatic injury to the ankle. It may also occur if the person has a pes planus or an (over)-pronated foot, which can cause compression in the sinus tarsi. Some characteristics are pain at the lateral side of the ankle and a feeling of instability. [1][2]
Clinically Relevant Anatomy[edit | edit source]
The sinus tarsi is a tunnel between the talus and the calcaneus, which contains some anatomic structures that can be injured in STS. Some ligaments founding this region are the interosseus talo-calcaneal ligament (number 5 in figure 1), the cervical ligament (number 6 in figure 1), and the medial, lateral and intermediate roots of the inferior extensor retinaculum.[1][2][3][4]
The sural nerve passes the sinus tarsi laterally, and some branches of it may run through the tarsi.[4]
Figure 1: an image of the ankle, with the sinus tarsi between the talus and calcaneus, and the ligaments in the sinus (numbers 5 and 6) (source: http://www.blackburnfeet.org.uk/hyperbook/trauma/ankleFx/ankleFxBasic1.htm)
Epidemiology /Etiology[edit | edit source]
Mostly the sinus tarsi syndrome occurs after a traumatic lateral ankle sprain. The ligaments of the sinus tarsi can be sprained or torn, and an inflammation and hemorrhage of the synovial recess in the sinus tarsi can occur. This happens in 70% of the cases.[1][2][4]
The sinus tarsi syndrome can also occur as a compression injury, for example to people who have flat or pronated feet. The talus and calcaneus are pressed together as a result of the deformation. This causes bone to bone contact of the talus and calcaneus, with inflammation or arthritis in the sinus.[1][4]
Characteristics/Clinical Presentation[edit | edit source]
The characteristics of the syndrome are pain at the lateral side of the ankle. “The pain is most severe when standing, walking on uneven ground or during the movements of supination and adduction of the foot”[1] People suffering from the sinus tarsi syndrome also have a feeling of instability (functional instability) in the hind foot.[1][4]
When the syndrome is a result of an inverted ankle sprain there is a major chance the lateral collateral ligaments of the ankle are also damaged, since the ligaments in the sinus tarsi are the last ones to tear with a traumatic ankle sprain.[1][4]
Differential Diagnosis[edit | edit source]
These common pathologies may give the same pain characteristics or symptoms:[5][6]
-ankle sprain
-calcaneal fracture
-talar fracture
-peroneal tendonitis
-subtalar joint arthritis
-tarsal tunnel syndrome
Diagnostic Procedures[edit | edit source]
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Examination[edit | edit source]
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Medical Management
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Physical Therapy Management
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References[edit | edit source]
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- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Taillard W, Meyer JM, Garcia J, Blanc Y. The Sinus Tarsi Syndrome. International Orthopaedics (SICOT) 1981; 5:117-130
- ↑ 2.0 2.1 2.2 Helgeson K. Examination and Intervention for Sinus Tarsi Syndrome. North American Journal of Sports Physical Therapy 2009 February; 4(1):29-37
- ↑ Rosenberg ZS, Beltran J, Bencardino JT. From the RSNA Refrecher Courses. MR Imaging of the Ankle and Foot. RadioGraphics 2000; 20:153-179
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 Meir Nyska, Gideon Mann, editors. The unstable ankle. Chapter 14: Sinus Tarsi Syndrome. United States: Human Kinetics Publishers, Inc. 2002. p144-120
- ↑ American Academy of Podiatric Sports Medicine. Sinus Tarsi Syndrome. http://www.aapsm.org/sinus_tarsi_syndrome.html (accessed 27/11/2010)
- ↑ MyFootShop. Sinus Tarsi Syndrome. http://www.myfootshop.com/detail.asp?Condition=Sinus%20Tarsi%20Syndrome (accessed 28/11/2010)
