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Transverse tarsal joint

The transverse tarsal joint, also known as the midtarsal joint or Chopart joint, is a complex articulation across the midfoot formed by two primary joints — the talonavicular joint medially and the calcaneocuboid joint laterally. These joints together form a functional unit that allows the foot to adapt between stability and flexibility during locomotion.

It lies between the hindfoot and midfoot, separating the talus and calcaneus posteriorly from the navicular and cuboid bones anteriorly. The joint plays a critical role in inversion and eversion movements of the foot and acts as a transitional link during gait, absorbing and redistributing mechanical loads.

Synonyms

  • Midtarsal joint

  • Chopart’s joint

  • Talonavicular–calcaneocuboid complex

Components

  1. Talonavicular joint: Between the head of the talus and the posterior surface of the navicular bone

  2. Calcaneocuboid joint: Between the anterior surface of the calcaneus and the posterior surface of the cuboid bone

Ligamentous Support

  • Plantar calcaneonavicular (spring) ligament: Supports talonavicular joint and maintains the medial longitudinal arch

  • Bifurcate ligament: Y-shaped structure connecting calcaneus to navicular and cuboid; stabilizes both components

  • Dorsal talonavicular and calcaneocuboid ligaments: Strengthen dorsal aspects

  • Long plantar ligament: Extends from calcaneus to cuboid and metatarsals, reinforcing plantar surface

  • Short plantar ligament: Deep to long plantar ligament; supports the calcaneocuboid joint

Relations

  • Superiorly: Talus and distal tibia

  • Inferiorly: Plantar fascia, long and short plantar ligaments

  • Medially: Talonavicular joint, spring ligament, and tibialis posterior tendon

  • Laterally: Calcaneocuboid joint and peroneus longus tendon

  • Anteriorly: Navicular and cuboid bones (articulating with cuneiforms and metatarsals)

  • Posteriorly: Calcaneus and subtalar joint

Nerve Supply

  • Medial plantar nerve (to talonavicular region)

  • Lateral plantar nerve (to calcaneocuboid joint)

  • Deep fibular nerve (articular branches anteriorly)

Function

  • Inversion and eversion: Primary movements occur around an oblique axis

  • Adaptation: Allows the foot to shift between flexible (during stance phase) and rigid (during push-off) states

  • Shock absorption: Distributes impact loads from hindfoot to midfoot

  • Arch maintenance: Spring and plantar ligaments preserve the medial and lateral longitudinal arches

  • Stability: Provides transverse stability to the midfoot during weight-bearing

Clinical Significance

  • Chopart joint dislocation: High-energy trauma causing disruption between hindfoot and midfoot

  • Arthritis and degeneration: Common in rheumatoid arthritis, post-traumatic arthritis, and flatfoot deformities

  • Ligament injury: Bifurcate and spring ligament tears may cause midfoot instability and arch collapse

  • Surgical relevance: Landmark for Chopart’s amputation; careful reconstruction needed to preserve arch mechanics

  • Imaging importance: MRI and CT crucial for evaluating joint alignment, cartilage, and ligament integrity

MRI Appearance

  • T1-weighted images:

    • Normal bone marrow: intermediate signal

    • Joint cartilage: smooth low signal

    • Ligaments: thin, low-signal bands

    • Effusion: intermediate-to-high signal (depending on fat content)

    • Synovitis or arthropathy: shows thickened synovium with intermediate signal

  • T2-weighted images:

    • Bone marrow: slightly darker than T1, maintaining intermediate signal

    • Joint fluid: bright (hyperintense)

    • Cartilage: thin, low signal but clearly delineated from subchondral bone

    • Ligament tears: bright hyperintense signal replacing normal dark fibers

    • Degenerative changes: joint space narrowing, marginal osteophytes, and subchondral cysts appearing hyperintense

  • STIR:

    • Bone marrow edema: bright hyperintense areas in adjacent bones

    • Ligament injury: high signal with loss of normal dark fibrillar appearance

    • Effusion: hyperintense in joint recesses

  • Proton Density Fat-Saturated (PD FS):

    • Cartilage: low-to-intermediate signal

    • Joint fluid: bright

    • Ligament injury or synovitis: bright hyperintensity in affected areas

    • Excellent for detecting spring or bifurcate ligament tears

  • T1 Fat-Sat Post-Contrast:

    • Synovitis: enhancing thickened synovial lining

    • Active inflammation or arthropathy: strong peripheral enhancement

    • Chronic degeneration: mild or patchy enhancement

CT Appearance

Non-Contrast CT:

  • Demonstrates bony architecture, joint alignment, and cortical continuity

  • Subtle fractures of talus, navicular, or cuboid visualized clearly

  • Degenerative changes: joint space narrowing, osteophytes, sclerosis

  • Ligament calcification or ossification seen as linear dense bands

Post-Contrast CT (standard):

  • Joint capsules and synovium may show enhancement in inflammatory arthritis

  • Better delineation of subchondral cysts, sclerosis, or erosive changes

MRI images

Transverse Tarsal Joint coronal cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000

MRI images

Transverse Tarsal Joint coronal cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000_00001

MRI images

Transverse Tarsal Joint sagittal cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000

MRI images

Transverse Tarsal Joint sagittal cross sectional anatomy 3T MRI AI enhanced radiology image-img-00000-00000_00001

CT image

Transverse Tarsal Joint ct axial

CT VRT 3D image

Transverse Tarsal Joint ct ver image

X Ray image

Transverse tarsal joint