The tarsal sinus (sinus tarsi) is the cone-shaped space between the talus and calcaneus, formed by the sulcus tali superiorly and the sulcus calcanei inferiorly. It contains the interosseous and cervical talocalcaneal ligaments, a fat pad, blood vessels, and proprioceptive nerve endings. The tarsal sinus communicates laterally with the tarsal canal medially.
Sinus tarsi syndrome from ligament disruption and synovitis within the tarsal sinus produces lateral hindfoot pain reproduced by direct palpation in the sinus and by hindfoot inversion. MRI identifies the pathological ligament signal change and synovitis. Corticosteroid injection into the sinus provides diagnostic confirmation when it relieves the pain and is also therapeutic in the short term.
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