Accessory Tarsal Navicular
| ICD-9 |
Classification / Treatment |
| Etiology / Epidemiology / Natural History |
Associated Injuries / Differential Diagnosis |
| Anatomy |
Complications |
| Clinical Evaluation |
Follow-up Care |
| Xray / Diagnositc Tests |
Review References |
synonyms:Accessory Navicular, accessory tarsal navicular
Accessory Navicular ICD-9
Etiology / Epidemiology / Natural History
- normal variant seen in up to 12% of population
- associated with flat feet
- medial arch pain with overuse
Anatomy
Clinical Evaluation
- Erythema, tenderness overlying the navicular tuberosity.
Xray / Diagnositc Tests
- A/P, lateral and oblique views of the foot. Often only seen on the external oblique xray.
- Bone scan can be helpful in unclear cases or patients with bilateral accessory naviculars
Classification / Treatment
- Type I: sesamoid contained within the posterior tibial tendon, 30%.
- Type II: most commonly symptomatic; 8-12mm ossicle seperated from the normal navicular.
- Type III: ossicle united to the navicular by a bony bridge forming a prominent navicular tuberosity.
- non-op semi-rigid orthosis with a medial arch support (Bennett J Pediatr Orthop 10:445;1990), activity modifications, shoe modifications to avoid pressure over prominent navicular, NSAIDS, most symptoms resolve spontaneously, short period of cast immobilization if severe.
- Surgical excision indicated if fails non-op treatment. Consider fixation for patients with very large accessory naviculars.w
Associated Injuries / Differential Diagnosis
Complications
Follow-up Care
Review References
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