Talotarsal dislocation is a pathologic condition that leads to a path of destruction within the foot and ankle and up the musculoskeletal chain. This condition is often shrugged off as normal or nothing to worry about, but with every step taken pathologic forces are at work destroying our body. This module shows objective radiographic parameters to accurately diagnose talotarsal dislocation deformity.

1. Interpretation of
Relaxed & Neutral Stance Position
Radiographs of the TaloTarsal Joint

2. Physician Benefit
• Documents objective radiographic evidence of
the talotarsal dislocation
• Identifies if there is a flexible/reducibility
deformity
• Rules out secondary deformities that may
need to be addressed

3. Patient Benefit
• Educates the patient on their deformity
• Assists the patient in determining the most
appropriate treatment course

4. Lateral View - Normal
• Articular facets are in
constant congruent
contact
• Forces are balanced on
the articular facets
• “Normal” amount of
joint mechanism
motion is available (no
more, no less)

5. Lateral View - Normal
Sinus tarsi:
in “open” position

6. Lateral View – TaloTarsal Dislocation
Partial to full obliteration
of the sinus tarsi.

7. Lateral View - Normal
Navicular Position:
Should overlap the dorsal half
of the cuboid.

8. Lateral View – TaloTarsal Dislocation
Navicular has fallen into
the plantar half of the
cuboid.

9. Lateral View - Normal
Sustentaculum Tali:
should be dorsally positioned.

10. Lateral View – TaloTarsal Dislocation
Sustentaculum tali
has dropped – plantar
position.

11. Lateral View - Normal
Cyma Line:
head of the talus should only
be slightly anterior to distal
aspect of the calcaneus.

12. Lateral View – TaloTarsal Dislocation
Anteriorly Deviated Cyma Line:
head of the talus has dislocated
anteriorly.
More than just a slightly anterior
to the distal aspect of the
calcaneus.

13. Lateral View - Normal
Talar Declination Angle:
< 21 degrees

14. Lateral View – TaloTarsal Dislocation
Talar Declination Angle:
> 21 degrees

15. Anterior-Posterior View
Normal TaloTarsal Joint Alignment
• Talar Second Metatarsal
– Ideal is 3-6
– Acceptable up to 16

16. Anterior-Posterior View
TaloTarsal Joint Dislocation
• Talar Second Metatarsal
> 16
• When the bisection of
the talus is medial to the
1st metatarsal.

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