The Spring Ligament Recess of the Talocalcaneonavicular Joint: Depiction on MR Images With Cadaveric and Histologic Correlation

OBJECTIVE. The objective of this study was to describe the anatomy and MR appearance of the spring ligament recess of the talocalcaneonavicular joint. SUBJECTS AND METHODS. Forty-nine MR examinations of the ankle with a spring ligament recess were prospectively collected. The size of the recess was measured. The presence of the following variables was recorded: talocalcaneonavicular joint effusion, ankle joint effusion, talar head impaction, acute lateral ankle sprain, chronic lateral ankle sprain, spring ligament tear, sinus tarsi ligament tear, talar dome osteochondral injury, and talonavicular osteoarthrosis. The Fisher exact test was performed to quantify the association of the talocalcaneonavicular effusion with the other variables. MR arthrography and dissection with histologic analysis were performed in two cadaveric ankles. RESULTS. Twenty-four men and 25 women (average age, 39 years; range, 21-77 years) were included in the study. The average size of the fluid collection was 0.4 x 0.8 cm (range, 0.2-0.9 x 0.4-1.5 cm). The prevalence of the measured variables was talocalcaneonavicular joint effusion, 67.3%; ankle joint effusion, 61.2%; talar head impaction, 32.7%; acute lateral ankle sprain, 28.6%; chronic lateral ankle sprain, 59.2%; spring ligament tear, 14.3%; sinus tarsi ligament tear, 12.2%; talar dome osteochondral lesion, 20.4%; and talonavicular osteoarthrosis, 18.4%. There was a higher prevalence of talar head impaction among individuals with talocalcaneonavicular joint effusion (p = 0.0522). Cadaveric study revealed communication between the talocalcaneonavicular joint and the spring ligament recess. CONCLUSION. The spring ligament recess is a synovium-lined, fluid-filled space that communicates with the talocalcaneonavicular joint. The recess should be distinguished from a tear of the plantar components of the spring ligament.