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Calcaneocuboid joint

The calcaneocuboid joint is a synovial saddle joint between the anterior surface of the calcaneus and the posterior surface of the cuboid bone. It forms the lateral component of the transverse tarsal (Chopart) joint, along with the talonavicular joint. This articulation plays a crucial role in hindfoot stability, lateral column support, and adaptability of the foot during gait.

Joint Capsule and Ligaments

  • Joint capsule: Fibrous capsule encloses the joint, lined by synovium

  • Dorsal calcaneocuboid ligament: Strengthens dorsal aspect of joint

  • Plantar calcaneocuboid (short plantar) ligament: Extends from calcaneus to cuboid, reinforces plantar surface

  • Long plantar ligament: Passes from calcaneus to cuboid and bases of lateral metatarsals, forming tunnel for peroneus longus tendon

  • Bifurcate ligament: Lateral limb attaches to calcaneocuboid joint, stabilizing lateral midfoot

Tendon and Muscle Relations

  • Plantar surface: Peroneus longus tendon passes beneath long plantar ligament, using cuboid groove as pulley

  • Dorsal surface: Extensor digitorum longus and peroneus tertius cross superficially

  • Lateral side: Peroneus brevis tendon passes close to joint

  • Medial side: Tibialis posterior tendon inserts partly onto cuboid (indirect relation to joint stability)

Function

  • Stability: Provides rigid support for lateral longitudinal arch

  • Adaptability: Permits inversion–eversion adjustments during gait

  • Shock absorption: Helps distribute forces across midfoot

  • Force transmission: Transfers loads from hindfoot to forefoot

Clinical Significance

  • Arthritis: Calcaneocuboid arthritis may occur in degenerative disease or after trauma

  • Sprains/injuries: Common in Chopart joint injuries, especially with inversion trauma

  • Subluxation: May occur with midfoot instability or peroneal tendon dysfunction

  • Surgical importance: Frequently involved in triple arthrodesis for hindfoot deformities

  • Imaging role: MRI and CT crucial for detecting arthritis, subluxation, and post-traumatic changes

MRI Appearance

  • T1-weighted images:

    • Normal joint surfaces: low-signal cortical bone with intermediate-to-high marrow signal (depending on fat content)

    • Cartilage: intermediate signal

    • Arthritis/degeneration: subchondral low-signal sclerosis or irregularity

  • T2-weighted images:

    • Normal cartilage: intermediate-to-bright signal

    • Effusion: bright hyperintense joint fluid

    • Arthritis: subchondral cysts and marrow edema appear as bright signal areas

  • STIR:

    • Suppresses marrow fat, highlighting edema, effusion, or ligament injury as bright hyperintense signal

  • Proton Density Fat-Saturated (PD FS):

    • Normal: uniform low-signal cartilage and marrow fat suppression

    • Pathology: bright hyperintense signal in effusion, ligament sprains, or bone marrow edema

  • T1 Fat-Sat Post-Contrast:

    • Normal: minimal joint lining enhancement

    • Synovitis or active arthritis: enhancing synovial tissue and pericapsular changes

MRI Arthrogram Appearance

  • Contrast fills calcaneocuboid joint space

  • Cartilage defects: contrast tracks into subchondral irregularities

  • Identifies capsular tears and subtle cartilage lesions not visible on standard MRI

CT Appearance

Non-Contrast CT:

  • Excellent for cortical bone detail

  • Normal joint: smooth articular margins

  • Pathology:

    • Arthritis: osteophytes, joint space narrowing, subchondral sclerosis

    • Trauma: fracture lines or subluxation

    • Chronic cases: flattening or irregularity of calcaneal and cuboid articular surfaces

CT Arthrogram Appearance

  • Contrast outlines the calcaneocuboid joint cavity

  • Cartilage defects: linear contrast-filled clefts

  • Capsular or ligamentous injury: contrast extravasation beyond joint

  • Superior to non-contrast CT for cartilage evaluation when MRI is contraindicated

CT VRT 3D image

Calcaneocuboid joint 3d

MRI image

Calcaneocuboid joint MRI axial cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000

MRI image

Calcaneocuboid joint MRI sagittal cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000

CT images

Calcaneocuboid joint sagittal CT cross sectional anatomy radiology image-img-00000-00000