The sinus tarsi is the cone-shaped space between the anterior and posterior subtalar joint facets, bordered by the talus above and the calcaneus below. It contains the interosseous talocalcaneal ligament, cervical ligament, fat, and nerve endings. The sinus tarsi opens laterally at the ankle and is palpable anterior to the lateral malleolus.
Sinus tarsi syndrome produces lateral hindfoot pain after ankle sprain from disruption of the interosseous talocalcaneal and cervical ligaments with synovitis and fibrosis in the sinus. It is confirmed by tenderness at the sinus tarsi opening (anterior to the fibula) and relief with sinus tarsi injection. MRI demonstrates fluid in the sinus and ligament disruption. Arthroscopic sinus tarsi debridement addresses refractory cases.
Chronic lateral hindfoot pain from sinus tarsi ligament injury and synovitis after ankle sprain, producing tenderness anterior to the fibula and instability feeling, managed by sinus tarsi injection or arthroscopic debridement.
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