Cuboid syndrome

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Cuboid syndrome
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Cuboid syndrome or cuboid subluxation describes a condition that results from subtle injury to the calcaneocuboid joint, [1] and ligaments in the vicinity of the cuboid bone, one of seven tarsal bones of the human foot.

Contents

This condition often manifests in the form of lateral (little toe side) foot pain and sometimes general foot weakness. Cuboid syndrome, which is relatively common but not well defined or recognized, [2] is known by many other names, including lateral plantar neuritis, cuboid fault syndrome, peroneal cuboid syndrome, dropped cuboid, locked cuboid and subluxed cuboid. [1] [3]

Signs and symptoms

A patient with cuboid syndrome usually seeks medical advice and attention complaining of pain, discomfort, or weakness along the lateral aspect of the foot between the fourth and fifth metatarsals and the calcaneocuboid joint. [1] The pain may radiate throughout the foot. [1] Tenderness may be elicited over the tendon of the peroneus longus muscle and an antalgic gait may be observed. [1] The pain may be observed in a controlled environment by standing on the toes or rolling the arches of the foot, as these motions tend to exercise the foot's calcaneocuboid joint and ligament, which are characteristically strained in a patient suffering from cuboid syndrome. [4] Also, the pain may come on suddenly or it may develop gradually and persist over time. Sometimes the pain is intermittent, subsiding partially or completely for a period of time before returning again. [3]

Causes

Cuboid syndrome may develop through either a single traumatic event such as an ankle sprain or insidiously with repetitive strain over time. [1] The exact etiology of cuboid syndrome remains unclear but many ideas have been proposed. Such ideas include excessive pronation of the foot, overuse injury, and inversion ankle sprains. [1] The favored idea is that the cuboid bone is forcefully everted while the calcaneus is inverted resulting in incongruity at the calcaneocuboid joint. [1] The condition mainly affects athletes, especially those whose activities incur a significant amount of pressure on their feet from jumping or running (such as ballet dancers [5] and runners) and those who place added strain on their feet during lateral maneuvering (such as tennis and basketball players [3] [4] ).

Risk factors

Suspected risk factors for cuboid syndrome include obesity, midtarsal instability, poorly fitting footwear, physical exercise, inadequate recovery from physical activity, physical training on uneven surfaces, and ankle sprains. [1]

Diagnosis

Treatment

Once diagnosed, a medical professional may treat cuboid syndrome by realigning (also known as reducing) the subluxed cuboid unless contraindications to manipulation are present such as inflammatory arthritis including gout, bony disease, neurovascular compromise, or a bone fracture. [1] [3] This form of manual manipulation of the foot should be done by a trained specialist, such as an orthopedic surgeon or podiatrist, or secondarily a chiropractor, osteopath, athletic trainer, osteopathic physician, or physical therapist. Further treatment may take into account other considerations, such as possible causes or aggravators (e.g. recommending that the patient be fit with custom orthotics if they are overprone). Fortunately, subluxed cuboids are generally quite treatable [4] and most patients return to a normal level of activity once the pain is brought under control. [3]

See also

Related Research Articles

<span class="mw-page-title-main">Foot</span> Anatomical structure found in vertebrates

The foot is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is a separate organ at the terminal part of the leg made up of one or more segments or bones, generally including claws and/or nails.

<span class="mw-page-title-main">Cuboid bone</span> Bone of the ankle

In the human body, the cuboid bone is one of the seven tarsal bones of the foot.

<span class="mw-page-title-main">Metatarsal bones</span> Five long bones in the foot

The metatarsal bones or metatarsus are a group of five long bones in the midfoot, located between the tarsal bones and the phalanges (toes). Lacking individual names, the metatarsal bones are numbered from the medial side : the first, second, third, fourth, and fifth metatarsal. The metatarsals are analogous to the metacarpal bones of the hand. The lengths of the metatarsal bones in humans are, in descending order, second, third, fourth, fifth, and first. A bovine hind leg has two metatarsals.

<span class="mw-page-title-main">Ankle</span> Region where the foot and the leg meet

The ankle, the talocrural region or the jumping bone (informal) is the area where the foot and the leg meet. The ankle includes three joints: the ankle joint proper or talocrural joint, the subtalar joint, and the inferior tibiofibular joint. The movements produced at this joint are dorsiflexion and plantarflexion of the foot. In common usage, the term ankle refers exclusively to the ankle region. In medical terminology," can refer broadly to the region or specifically to the talocrural joint.

<span class="mw-page-title-main">Sprain</span> Damage to one or more ligaments in a joint

A sprain is a soft tissue injury of the ligaments within a joint, often caused by a sudden movement abruptly forcing the joint to exceed its functional range of motion. Ligaments are tough, inelastic fibers made of collagen that connect two or more bones to form a joint and are important for joint stability and proprioception, which is the body's sense of limb position and movement. Sprains may be mild, moderate, or severe, with the latter two classes involving some degree of tearing of the ligament. Sprains can occur at any joint but most commonly occur in the ankle, knee, or wrist. An equivalent injury to a muscle or tendon is known as a strain.

<span class="mw-page-title-main">Pes cavus</span> Medical condition

Pes cavus, also known as high arch, is a human foot type in which the sole of the foot is distinctly hollow when bearing weight. That is, there is a fixed plantar flexion of the foot. A high arch is the opposite of a flat foot and is somewhat less common.

<span class="mw-page-title-main">Hammer toe</span> Medical condition

A hammer toe, hammertoe or contracted toe is a deformity of the muscles and ligaments of the proximal interphalangeal joint of the second, third, fourth, or fifth toe, bending it into a shape resembling a hammer. In the early stage, a flexible hammertoe is movable at the joints; a rigid hammertoe joint cannot be moved and usually requires surgery.

<span class="mw-page-title-main">Flat feet</span> Foot arch deformity

Flat feet, also called pes planus or fallen arches, is a postural deformity in which the arches of the foot collapse, with the entire sole of the foot coming into complete or near-complete contact with the ground. Sometimes children are born with flat feet (congenital). There is a functional relationship between the structure of the arch of the foot and the biomechanics of the lower leg. The arch provides an elastic, springy connection between the forefoot and the hind foot so that a majority of the forces incurred during weight bearing on the foot can be dissipated before the force reaches the long bones of the leg and thigh.

<span class="mw-page-title-main">Tarsus (skeleton)</span> Bones of the foot

In the human body, the tarsus is a cluster of seven articulating bones in each foot situated between the lower end of the tibia and the fibula of the lower leg and the metatarsus. It is made up of the midfoot and hindfoot.

<span class="mw-page-title-main">Tarsal tunnel syndrome</span> Medical condition

Tarsal tunnel syndrome (TTS) is a nerve compression syndrome or nerve entrapment syndrome causing a painful foot condition in which the tibial nerve is entrapped as it travels through the tarsal tunnel. The tarsal tunnel is found along the inner leg behind the medial malleolus. The posterior tibial artery, tibial nerve, and tendons of the tibialis posterior, flexor digitorum longus, and flexor hallucis longus muscles travel in a bundle through the tarsal tunnel. Inside the tunnel, the nerve splits into three segments. One nerve (calcaneal) continues to the heel, the other two continue on to the bottom of the foot. The tarsal tunnel is delineated by bone on the inside and the flexor retinaculum on the outside.

<span class="mw-page-title-main">Ankle fracture</span> Medical condition

An ankle fracture is a break of one or more of the bones that make up the ankle joint. Symptoms may include pain, swelling, bruising, and an inability to walk on the injured leg. Complications may include an associated high ankle sprain, compartment syndrome, stiffness, malunion, and post-traumatic arthritis.

<span class="mw-page-title-main">Subtalar joint</span>

In human anatomy, the subtalar joint, also known as the talocalcaneal joint, is a joint of the foot. It occurs at the meeting point of the talus and the calcaneus.

<span class="mw-page-title-main">Sprained ankle</span> Medical condition

A sprained ankle is an injury where sprain occurs on one or more ligaments of the ankle. It is the most commonly occurring injury in sports, mainly in ball sports such as basketball, volleyball, football, and tennis.

Foot and ankle surgery is a sub-specialty of orthopedics and podiatry that deals with the treatment, diagnosis and prevention of disorders of the foot and ankle. Orthopaedic surgeons are medically qualified, having been through four years of college, followed by 4 years of medical school or osteopathic medical school to obtain an M.D. or D.O. followed by specialist training as a resident in orthopaedics, and only then do they sub-specialise in foot and ankle surgery. Training for a podiatric foot and ankle surgeon consists of four years of college, four years of podiatric medical school (D.P.M.), 3–4 years of a surgical residency and an optional 1 year fellowship.

<span class="mw-page-title-main">Pigeon toe</span> Medical condition affecting the feet

Pigeon toe, also known as in-toeing, is a condition which causes the toes to point inward when walking. It is most common in infants and children under two years of age and, when not the result of simple muscle weakness, normally arises from underlying conditions, such as a twisted shin bone or an excessive anteversion resulting in the twisting of the thigh bone when the front part of a person's foot is turned in.

<span class="mw-page-title-main">Knee pain</span> Medical condition

Knee pain is pain in or around the knee.

<span class="mw-page-title-main">Ankle problems</span> Medical condition

Ankle problems occur frequently, having symptoms of pain or discomfort in the ankles.

<span class="mw-page-title-main">Sinus tarsi</span> Section of the hindfoot

The sinus tarsi, also known as the talocalcaneal sulcus, is a cylindrical canal in the hindfoot. It has a complex anatomy, with five ligamentous structures and a pad of adipose tissue (fat). The tarsal canal opens up into the sinus tarsi, however, the tarsal canal is a distinct structure.

<span class="mw-page-title-main">Mueller–Weiss syndrome</span> Osteonecrotic disease of the foot

Mueller–Weiss syndrome, also known as Mueller–Weiss disease, is a rare idiopathic degenerative disease of the adult navicular bone characterized by progressive collapse and fragmentation, leading to mid- and hindfoot pain and deformity. It is most commonly seen in females, ages 40–60. Characteristic imaging shows lateral navicular collapse. This disease had been historically considered to be a form of adult onset osteonecrosis, with blood flow cutoff to the navicular.

<span class="mw-page-title-main">Sinus tarsi syndrome</span> Disorder of pain and tenderness in the sinus tarsi

Sinus tarsi syndrome is the clinical disorder of pain and tenderness in the sinus tarsi, which is a lateral tunnel in the foot at the junction of the hindfoot and the midfoot, between the ankle and the heel. Most of the time, sinus tarsi syndrome onsets after ankle sprains, however there can be other causes. There are a variety of treatments, divided into conservative treatments such as physical and orthotic therapy, and more invasive ones such as cortisone injections. The condition is somewhat poorly understood and is subject to heavy debate in the medical community.

References

  1. 1 2 3 4 5 6 7 8 9 10 Durall, CJ (November 2011). "Examination and treatment of cuboid syndrome: a literature review". Sports Health. 3 (6): 514–519. doi:10.1177/1941738111405965. PMC   3445231 . PMID   23016051.
  2. Baravarian, Babak (March 2005). "Diagnostic Dilemmas: A Guide To Understanding And Treating Lateral Column Pain". Podiatry Today 18(3). Archived from the original on 2006-03-22. Retrieved 22 June 2020.
  3. 1 2 3 4 5 Caselli, Mark A.; Pantelaras, Nikiforos (October 2004). "How to Treat Cuboid Syndrome in The Athlete". Podiatry Today 17 (10). Archived from the original on 2006-02-21. Retrieved 22 June 2020.
  4. 1 2 3 Allen, Rick (November 2002). "Subluxated Cuboid Bone" (Reprinted from Instep Dance Magazine). Archived from the original on 2006-05-28. Retrieved June 22, 2020 via Cascade Wellness Clinic.
  5. Marshall, Peter; Hamilton, William G. (1992). "Cuboid subluxation in ballet dancers". The American Journal of Sports Medicine. 20 (2): 169–175. doi:10.1177/036354659202000213.