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Absence of tarsal navicular bone - bilateral

Case contributed by Bahman Rasuli
Diagnosis certain

Presentation

Chronic bilateral ankle and foot pain.

Patient Data

Age: 45 years
Gender: Male

Bilateral absence of navicular bones.

Articulation of cuneiform bones with the talus in the proximal and first metatarsal base in the distal part. 

Right ankle and foot

mri

Congenital absence of the navicular bone.

Degenerative changes between the navicular and cuneiform bones as decreased space, and subchondral edema and cystic changes.

Accessory ossicle next to the talus and medial cuneiform bones in the medial side.

Elongated talar neck and enlarged size of the talar head.

​Extension of the foot dorsal intrinsic muscles (extensor hallucis brevis and extensor digitorum brevis) within the external opening of sinus tarsi.

Termination of the posterior tibialis tendon on the accessory ossicle and talus head at the inferomedial aspect.

Left ankle and foot

mri

Minimal mortise joint effusion.

Congenital absence of the navicular bone.

Degenerative changes between the navicular and cuneiform bones as decreased space, and subchondral edema and cystic changes.

Elongated talar neck and enlarged size of the talar head.

Extension of intrinsic muscles of the foot in dorsal aspect (extensor hallucis brevis and extensor digitorum brevis) to the external opening of sinus tarsi.

Termination of the posterior tibialis tendon on the talus head at the inferomedial aspect.

Case Discussion

The absence of the tarsal navicular bone is extremely rare and it's often difficult to recognize something that is not there.

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