BACKGROUND Bony lesions of the tarsal bones in general and, more specifically, the cuboid are rare and therefore sparsely covered in the existing literature as well as uncommonly seen in radiology. Combined with nonspecific clinical symptoms, they can be challenging to identify and characterise on imaging. Prompt and accurate diagnosis is paramount because the responsible entities include malignant tumours. To our knowledge, this is among the largest case series of cuboid lesions reported. METHODS A retrospective analysis of 16 patients presenting to a tertiary orthopaedic oncology centre with lesions of the cuboid bone was conducted by a musculoskeletal radiologist with over 20 years of experience. Key radiological and demographic features were extracted and compared within and across pathologies to identify common and distinguishing features. Descriptive statistics were calculated (counts, percentages, median and interquartile range); inferential tests were not performed because of the small sample. RESULTS A total of 16 patients were included, with 13 females (81%) and 3 males (19%). Median age at diagnosis was 48.5 years (IQR 46.5), with the youngest two patients presenting at 8 years of age. Two lesions (13%) were metastases (one lung and one colon), two (13%) were giant cell tumours (GCT) and two (13%) were Ollier's disease; every other diagnosis occurred once. All radiological features were extracted and compared. CONCLUSION Despite their rarity, cuboid lesions do occur and present with a wide range of pathology. This case series compares the key identifying features of such lesions to inform radiologists' future practice when approaching cuboid lesions, supporting appropriate diagnosis.
Introduction End-stage ankle arthritis is a debilitating condition presenting with pain and functional limitations. Surgical management typically involves ankle arthrodesis (AA) or total ankle replacement (TAR). This study aimed to investigate demographic, socioeconomic, and clinical factors associated with receiving TAR versus AA in England. Methods A retrospective cohort analysis was conducted using Hospital Episode Statistics (HES) data for all elective AAs and TARs performed in England between April 2013 and March 2025. Patients aged 17 years and over were included. Multivariable logistic regression was used to assess associations between procedure type and patient-level factors. Results A total of 26,331 procedures were identified, comprising 8836 (33.6%) TARs and 17,495 (66.4%) AAs. Older age and female sex were independently associated with increased odds of TAR (age ≥80 years relative to 17–29 years: odds ratio (OR) 12.89, 95% confidence interval (CI) 9.86–17.29; female sex: OR = 1.46, 95% CI 1.36–1.56). Relative to no frailty, mild and moderate frailty increased the likelihood of TAR, whereas severe frailty reduced it (OR 0.51, 95% CI 0.37–0.71). Patients from less deprived areas were more likely to receive TAR (IMD 5th quintile relative to 1st quintile OR 1.40, 95% CI 1.25–1.58). Compared with White patients, those of Asian ethnicity were less likely to undergo TAR. Conclusion Older age, female sex, lower deprivation, and mild-to-moderate frailty are associated with higher odds of TAR, while Asian ethnicity, higher deprivation and severe frailty are associated with reduced likelihood. These findings likely highlight patterns in clinical decision making, but may also suggest possible variation in access to ankle arthroplasty.
