A RARE CAUSE OF CHRONIC HINDFOOT PAIN: TALARCYST ADJACENT TO SUBTALAR JOINT, TREATED BYARTHROSCOPY

摘要

MALE PATIENT, AGED 26, CAME TO THE CONSULTATION FOR CONTINUOUSMODERATE PAIN IN THE LEFT HINDFOOT. PAIN WITH NOCTURNALEXACERBATION, GOT WORSE IN THE LAST 6 MONTHS. THE PATIENT WAS A RUGBYPLAYER AND PRESENTED TWO YEARS AGO AN ANKLE SPRAIN, IMMOBILIZED FORTHREE WEEKS. EVOLUTION SHOWED SLOW IMPROVEMENT, BUT INCOMPLETE,WITH PAIN DURING THE EFFORT AND LATER DURING THE NIGHT. AFTER 18MONTHS OF THE INJURY, THE PATIENT STOPPED TRAINING, BUT THE PAINPERSISTED.INITIAL CLINICAL EXAMINATION SHOW PAIN ON PALPATION IN THE RIGHTSUBTALAR JOINT ON THE LATERAL SIDE AND PAIN DURING SUPINATION.COMPUTED TOMOGRAPHY SHOWS TALAR NECK BONE CYST ADJACENT TO THESUBTALAR JOINT , ABOUT 7/5 MM.THE TREATMENT WAS A POSTERIOR ANKLE ARTHROSCOPY. IN THE SUBTALARJOINT THE CYST WAS SPOTTED AND TREATED BY CURETTAGE AND CANCELLOUSBONE AUTOGRAFTING (HARVESTED FROM THE TIBIAL METAPHYSIS). THEPATIENT RESUMED WALKING WITH PARTIAL WEIGHT BEARING THE DAY AFTERSURGERY. REPORTED CHRONIC PAIN DISAPPEARED IMMEDIATELY AFTERSURGERY. AT 6 WEEKS WAS WALKING PAIN FREE, AND IN THREE MONTHSRADIOGRAPHS SHOWED BONE HEALING. AT 6 MONTHS, THE PATIENT RETURNEDTO SPORT.