Subtalar synovitis vs. ganglions

Subtalar Pathology

Description of patient (type of occupation, indication of age, intensity of sport):

31 year old healthy no history of trauma.
18 months history of ankle pain and lateral swelling

History and previous treatment:


Current complaints:

pain and limp in ankle

Physical examination:

normal heel and foot alingment.
mass posterolateral and anterolateral to the lateral malleolus.
otherwise normal.
subtalar motion intact



Additional investigation (CT/MRI):
[Picture 1 + 2]
Synovitis of subtalr joint - going posterolateral between FHL and peroneals and going anterior to sinus tarsi.


Case summary:

31 year old male, synovitis of subtalar origin

Question(s) to this case:

how would you treat?
excision open?
excision combined posterior arthroscopy plus sinus tarsi open?
subtalar fusion primary?


What does the radiologist say:
ganglion or chronic synovitis. In case of synovitis it probably is villunodular synovitis.
Theatment in both cases is to resect. I would go by endoscopic aproach starting with 2 portal hindfoor aproach and then a lateral 2-portal sinus tarsi aproach for the anterior part. If you are unconfotable with the sinustarsi aproach then you can perform this part open. Please give us some feedback on the outcome(pathlogy outcome etc)