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Coalition by MSKMRI JEE EUN LEE.pdf
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Accessory articular facets are normal anatomic variants of the talocalcaneal joint but can mimic or associate with pathology.
Accessory Anterolateral Talar Facet (AALTF):
- Extension of posterior talar facet cartilage, seen anterior to the lateral talar process.
- Prevalence: ~3–10%.
- MRI findings: strongly associated with focal abutting bone marrow edema (FABME), sinus tarsi edema, and subtalar irritation (may cause peroneal spastic flatfoot).
- Coalition link: up to 29% of patients with AALTF also have a tarsal coalition, most often talocalcaneal (especially extra-articular or middle facet). Always search for both.
Posteromedial Accessory Facet:
- Located at posterior sustentaculum tali and anteroinferior postero-medial talar process.
- Key point: smooth margins → normal variant, not coalition.
Radiology perspective:
- On MRI, AALTF appears as cartilage extension beyond the lateral talar process, often with adjacent bone marrow edema.
- Recognizing these facets avoids misdiagnosis and helps explain otherwise unexplained subtalar pain.
#Radiology, #MSKMRI, #SubtalarJoint, #AALTF, #FootMRI, #CoalitionImaging, #RadiologyEducation, #OrthopedicImaging, #MRIteaching, #RadiologistLife
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