Patients with sinus tarsi syndrome typically have normal radiographs. Subtalar ligaments can also be evaluated for injury, but they are sometimes not visualized because of inflammatory infiltration or simply because they have been disrupted. Calcaneofibular ligament injury, meniscoid lesions, and talar osteochondral injury can also be detected with MRI, but the technique should be reserved only for cases in which the diagnosis is unclear or if surgery is being considered. Before the advent of MRI, diagnosis was often done with arthrography, but the technique is rarely used now because of its invasive nature. Effective Treatment Conservative therapy.
Initial treatment is conservative.
In many cases, symptoms can be completely relieved by repeated injections of local anesthetic and corticosteroid into the sinus tarsi. Care must be taken, because repeated injections of corticosteroid are associated with several risks. Local side effects include infection, subcutaneous atrophy, and skin depigmentation. Systemic side effects of oral corticosteroids include menstrual irregularity, osteoporosis, adrenal suppression, impaired glucose tolerance, and steroid arthropathy. Using proper technique and not exceeding the recommended maximum steroid dosage can minimize side effects.