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Alleviation of pain with injection of anesthetic may be diagnostic
ABSTRACT: Inflammation of the subtalar joint can make inversion and eversion of the foot uncomfortable. The pain of sinus tarsi syndrome implicates injury to the interosseous talocalcaneal ligament. This syndrome also may be associated with subtalar instability after an inversion ankle sprain and may be seen in inflammatory conditions of the foot and ankle. A lateral approach is preferred for injection of the subtalar joint. For sinus tarsi injection, advance the needle toward the medial malleolus. Infusing corticosteroid ½ to 1 inch deep into the sinus tarsi increases the chances of success. (J Musculoskel Med. 2008;25:29-30)
The subtalar joint is a superficial joint formed by the articulation of the talus and the calcaneus. Inflammation can make inversion and eversion of the foot uncomfortable (as opposed to pain with dorsiflexion and plantar flexion in the true ankle joint). In inflammatory arthritis, the subtalar joint may communicate with the ankle joint and obviate the need for injection. Injection is challenging because this joint is small and difficult to access.
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