Overview This condition has been observed in multiple family members and has propensity to occur slightly more in females than males. For most individuals this condition is a non-issue and most people who have them never have a problem with them. Over the years when x-raying patients for other problems I will point out that they have an extra bone in their foot and the usual response from the patient is nothing more than a yawn.
Causes An injury to the fibrous tissue connecting the two bones can cause something similar to a fracture. The injury allows movement to occur between the navicular and the accessory bone and is thought to be the cause of pain. The fibrous tissue is prone to poor healing and may continue to cause pain. Because the posterior tibial tendon attaches to the accessory navicular, it constantly pulls on the bone, creating even more motion between the fragments with each step.
Symptoms Symptoms of accessory navicular include. Bone lump on the inside of the foot. Redness and swelling. Pain.
Diagnosis Diagnosis starts by speaking with the patient about symptoms. The physician will look at the foot and examine it for signs of an accessory navicular. By putting pressure on the area, the doctor may determine its presence simply by the presence of pain. The muscle, joint, and the overall structure of the foot may be considered, as well as the way in which the patient walks. If a diagnosis of accessory navicular syndrome is made, an X-ray or MRI may be ordered to confirm diagnosis.
Non Surgical Treatment Rest is the most important factor in relieving your pain. You may need to immobilize your foot to allow the affected tissues to rest enough that they can heal. Icing the area will help decrease any inflammation and swelling. Our staff may recommend anti-inflammatory medications as well. Most likely you will need to change your footwear-and possibly add orthotics-to accommodate your bony prominence and relieve strain in the midfoot. Sometimes physical therapy may be able to help strengthen tissues and prevent additional injuries.
Surgical Treatment The above non-surgical options should be enough to treat accessory navicular syndrome. If they fail, a surgery would be necessary to remove the extra bone that has been causing the problems. The most common procedure for this condition is known as the Kidner procedure where a small incision is made over the navicular bone. The accessory navicular What is the tendon at the back of your ankle? identified and dissected free from the posterior tibial tendon. The posterior tibial tendon is then reattached to the remaining navicular bone.
Overview The accessory navicular (os navicularum or os tibiale externum) is an extra bone or piece of cartilage located on the inner side of the foot just above the arch. It is incorporated within the posterior tibial tendon, which attaches in this area. An accessory navicular is congenital (present at birth). It is not part of normal bone structure and therefore is not present in most people. People who have an accessory navicular often are unaware of the condition if it causes no problems. However, some people with this extra bone develop a painful condition known as accessory navicular syndrome when the bone and/or posterior tibial tendon are aggravated. Many people with accessory navicular syndrome also have flat feet (fallen arches). Having a flat foot puts more strain on the posterior tibial tendon, which can produce inflammation or irritation of the accessory navicular.
Causes This painful foot condition is caused by an extra bone in the foot called the accessory navicular. Only about 10% of people have this bone (4 to 21%), and not all of them will develop any symptoms. The navicular bone is one of the normal tarsal bones of the foot. It is located on the inside of the foot, at the arch.
Symptoms It?s common for any symptoms to present during adolescence, when bones are maturing, though problems may not occur until adulthood. You may notice a bony prominence on the inner side of the midfoot. There may or may not be redness and swelling around this bump, especially if it rubs against footwear. You may be prone to blisters or sores in the area. Pain generally involves a vague ache or throbbing in the midfoot and arch as well, especially when you?re active. Many people with this syndrome develop flat feet, too, which How can we increase our height? create additional strain in the foot.
Diagnosis Diagnosis is fairly simple based on an examination by your doctor. He or she will palpate the navicular bone, and based on the location of pain will suspect an accessory navicular. The doctor will also observe your gait to see if you are flatfooted. At this point an x-ray will make the definitive diagnosis. Other causes of pain in the same area of the foot would include a fracture of the navicular bone or possibly tendonitis or even a partial tear of the tibialis posterior tendon that inserts into the navicular. In these cases there is usually a history of trauma. People with a naturally "large" navicular bone may also develop a bursitis due to chronic shoe pressure.
Non Surgical Treatment Treating accessory navicular syndrome is focused on relieving symptoms. Some treatment methods are Icing to reduce swelling. Immobilization with a cast or walking boot to reduce inflammation and promote healing. Medications to reduce pain and inflammation. Physical therapy to strengthen muscles. Orthotics to support the arch. Surgery may be needed to remove the accessory bone and reshape the area if other methods are not successful.
Surgical Treatment Surgical treatment of the accessory navicular syndrome with simple excision has the advantages of less invasive to the posterior tibial tenden and the medial longitudinal arch of the foot, shorter time of immobilization of the foot and stay in hospital, small incision and good clinical results. This procedure is one of the best selective treatments for the accessory navicular syndrome, especially for the patients without flatfoot deformity and old sprain injury.