Accessory navicular bone

Case contributed by Mohammad A. ElBeialy
Diagnosis almost certain

Presentation

Medial foot pain

Patient Data

Age: 30 years
Gender: Male
mri

Type II accessory navicular bone with cortical irregularity and subchondral degenerative marrow oedema signal along the bony synchondrosis at the medial posterior aspect of the navicular bone. Intact tibialis posterior tendon.

x-ray

Type II accessory navicular bone with mild subchondral sclerosis and cortical irregularity in a different patient with medial navicular pain. 

Case Discussion

An os tibiale externum (or accessory navicular / os naviculare) is a large ossicleadjacent to the medial side of the navicular bone. Most cases are asymptomatic but  it may cause a painful tendinosis.

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