Accessory Tarsal Navicular

 

synonyms:Accessory Navicular, accessory tarsal navicular

Accessory Navicular ICD-9

Accessory Navicular Etiology / Epidemiology / Natural History

  • normal variant seen in up to 12% of population
  • associated with flat feet
  • medial arch pain with overuse

Accessory Navicular Anatomy

Accessory Navicular Clinical Evaluation

  • Erythema, tenderness overlying the navicular tuberosity.

Accessory Navicular Xray / Diagnositc Tests

  • A/P, lateral and obliqueviews 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

Accessory Navicular 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

Accessory Navicular Associated Injuries / Differential Diagnosis

Accessory Navicular Complications

Accessory Navicular Follow-up Care

Accessory Navicular Review References

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