Sinus Tarsi Syndrome is Clinical disorder characterised by specific symptoms and signs localised to the sinus tarsi, which refers to an opening on the outside of the foot between the ankle and heel bone. Cause can be due to an inversion (rolling out) ankle sprain or can be due to a “pinching” or impingement of the soft tissues in the sinus tarsi due to a very pronated foot. Patients present with localize pain to the sinus tarsi region with a feeling of instability and aggravation by weight bearing activity. These patients do poorly on uneven surfaces. Examination reveals pain to palpation of the sinus tarsi with aggravation on foot inversion or eversion. Looseness and instability of the ankle and foot joints may be present as well.  Diagnosis may include x-rays, bone scan, CT scan and MRI evaluation. Injection with local anesthetic is diagnostic for localizing this problem to the sinus tarsi. Many times this is a diagnosis make by excluding other common problems in the foot as definitive diagnostic findings are rarely present. After a diagnosis is established conservative treatment can be initiated which is generally very effective in eliminating the problem. Treatment may include anti-inflammatories, stable shoes, period of immobilisation, ankle sleeve and custom made orthotics which your Podiatrist can make for you. Rarely is surgery indicated and if needed open surgery (through an incision) or closed surgery (via arthroscopy) can be considered. Excellent results should be expected but surgery is not a panacea and should be considered as a last resort. Sinus Tarsi Syndrome is a problem that can occur commonly after an ankle sprain or in someone who has a severely  pronated foot. Diagnosis is critical as this will dictate appropriate treatment which can differ significantly from other common problems seen in the foot and ankle. Conservative treatment is usually effective and surgery is rarely needed and should be considered after an adequate and thorough trial of conservative treatment.










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