Os tibiale externum
Pain along the medial arch of foot
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Accessory navicular bone with mild os- navicular articular edema. Mild intratendinous edema in tibialis posterior as it inserts into the os.
Accessory navicular bone can be totally asymptomatic or at time cause some amount of friction with the navicular articulation resulting in focal marrow edema and secondary foot pain as in this case. Patient was treated conservatively.