The talonavicular joint is one of the joints that makes up the human ankle, and it plays a big role when it comes to allowing the foot and lower leg to articulate. Three separate joints at the back of the foot together make what people think of as the ankle joint; orthopedically speaking, the "ankle" is technically the first of these joints, located at the junction between the tibia, fibula, and talus bone. The talonavicular joint is the lowest of the three ankle joints, spanning to the mid-foot. Each person generally has two — one on each foot. The joints' main role is to provide support to the foot and to allow flexibility when doing things like walking or running. People don’t usually think about these joints until they get inflamed or otherwise cause pain. Joint disorders like arthritis are common in this part of the foot, and problems can also come as the result of injury or use-related strain. In most cases joint problems can be resolved with a combination of rest, medication, and physical therapy, though surgery is required in some of the most severe cases.
Location and Basics
At this part of the ankle, located on the inside of the middle foot, the talus and navicular bones meet up or join. Describing what exactly the joint is can be difficult outside of a strictly biological context, but in simple terms it’s the space between where the bones meet that allows for bending and movement. There are many different joints in the foot, and most — the talonavicular included — are coated with ligaments and cartilage to lubricate the bones and prevent friction. This joint neighbors two additional structures, the calcaneocuboid and the subtalar joints.
This joint has a couple of important jobs, but its primary role is usually to work alongside the other joints of the ankle and food to provide stability across the midfoot and to allow the foot and ankle to flex during walking and other physical activities. The series of small articulations in the ankle and foot make it one of the most complex areas of the human skeleton, rivaled only by the hands in terms of the number of involved bones, the intricacy of the joints, and the need for precise coordination.
Joint Problems and Disorders
As people age, arthritis in this joint is very common, especially if someone has a history of athleticism or hard physical labor. Arthritis may manifest initially as a feeling of pain, soreness, and tenderness in the midfoot. The patient may notice that the area around the talonavicular joint feels hot and the surrounding tissue can swell, which may make shoes uncomfortable. It is also possible to break this area of the foot with crush injuries or severe falls.
Treatment Options and Prognosis
Treatment of a talonavicular joint disorder usually starts with a physical examination and X-ray. The doctor or other healthcare provider may order additional imaging, such as an MRI study, if there are concerns about hairline fractures or other injuries that may be difficult to detect on an X-ray or other scan. Slides may show a break or the tell-tale signs of inflammation such as swelling or joint pressure. In severe arthritis, inflammation can cause bone spurs to develop along the bones of the ankle, and these may exacerbate the pain and soreness. Spurs are jagged edges that can irritate cartilage and cause painful friction during movement.
Conservative treatment can include anti-inflammatory medications, rest, and hot or cold compresses. If these measures do not work, the doctor may recommend a brace or walking boot to stabilize the joint and give it a chance to recover, and consultation with a trained physical therapist is often recommended, too. Surgery may be necessary in serious talonavicular injuries. A surgeon can pin the bones of the joint if necessary in addition to trimming away any bone spurs. It may also be possible to perform a minimally invasive procedure through small incisions around the ankle joint to limit the risk of complications and speed the patient's healing time.