Normal Anatomy and Traumatic Injury of the Midtarsal (Chopart) Joint Complex

Musculoskeletal Imaging

Normal Anatomy and Traumatic Injury of the Midtarsal (Chopart) Joint Complex: An Imaging Primer

William R. Walter , Anna Hirschmann, Erin F. Alaia, Monica Tafur, Zehava S. Rosenberg

Author Affiliations

• From the Department of Radiology, Musculoskeletal Division, NYU Langone Orthopedic Hospital, 301 E 17th St, 6th Floor, New York, NY 10003 (W.R.W., E.F.A., Z.S.R.); Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland (A.H.); and Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (M.T.).
• Address correspondence to W.R.W. (e-mail: William.walter@nyumc.org).

Published Online:Nov 30 2018https://doi.org/10.1148/rg.2019180102

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Abstract

This article reviews imaging of normal Chopart joint anatomy and the spectrum of traumatic injuries that occur at the joint complex, focusing on the normal MRI appearance of its stabilizing ligaments and emphasizing typical traumatic injuries, including midtarsal sprains and Chopart fracture-dislocations.

The midtarsal (Chopart) joint complex consists of the talonavicular and calcaneocuboid joints and their stabilizing ligaments. Detailed assessment of this complex at MRI can be challenging owing to frequent anatomic variation and the small size of the structures involved. Nevertheless, a wide spectrum of pathologic conditions affect the joint complex, and its imaging evaluation deserves more thorough consideration. This review focuses on MRI evaluation of normal ligamentous anatomy and common variations about the Chopart joint, presenting practical imaging tips and potential diagnostic pitfalls. Imaging findings across a spectrum of traumatic Chopart joint injuries are also reviewed, from midtarsal sprains to Chopart fracture-dislocations. Midtarsal sprains—commonly associated with ankle inversion injuries—are emphasized, along with their often predictable radiographic and MRI injury patterns.