Accessory navicular syndrome

Case contributed by Mostafa Elfeky
Diagnosis almost certain


Pain at medial aspect of left foot.

Patient Data

Age: 35 years
Gender: Male

Type II accessory navicular ossicle is noted. No fracture lines detected.


Left os naviculare is noted; this is associated with mild T2 hyperintensity of the intervening synchondrosis and subchondral moderate marrow edema along the opposing articular surfaces, reflecting os naviculare syndrome.

Right os naviculare is noted with no signs of complications. 

Case Discussion

Bilateral type II accessory navicular bone (os naviculare) is noted, with subchondral marrow edema on the left one reflecting accessory navicular syndrome. Usually presents with pain on the medial aspect of the foot over the ossicle area.

The diagnosis could be suspected first if the pain radiograph shows type II accessory navicular bone which is a normal variant. MRI confirms the diagnosis by showing subchondral edema and high T2 signal at the synchondrosis.


Case courtesy; Dr Rim Bastawy, Lecturer of radiodiagnosis, Alexandria University, Egypt.

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