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Dorsal avulsion fracture of the navicular bone

Case contributed by Ashesh Ishwarlal Ranchod
Diagnosis almost certain

Presentation

Blunt trauma. The patient twisted her ankle and presents with lateral compartment including hindfoot pain and swelling.

Patient Data

Age: 16 years
Gender: Female

There is lateral malleolar soft tissue swelling and overlying the dorsal navicular bone with features suggestive of an avulsion fracture injury.

Case Discussion

Features suggest a dorsal avulsion fracture injury of the navicular bone and likely a dorsal talonavicular ligament injury. This appeared consistent with clinical examination and sites of pain and swelling.

Os supranaviculare, a normal variant, must always be considered in the differential diagnosis and can be excluded with further MRI evaluation. Ultrasound and/or CT imaging may be of additional value when an MRI is not immediately available or accessible.

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