A is for Accessory Navicular

September 7, 2013

The Accessory Navicular is an extra bone or ossicle that is on the medial side of the navicular bone. There are several types and some can be painful It is sometimes called os tibiale externum.

Accessory Navicular

An accessory navicular is an extra bone or piece of cartilage that is present in some individuals. It is a congenital condition, meaning it is present from birth, and is estimated to occur in about 10% of the population.

The navicular bone is one of the small bones located in the midfoot, on the inside of the foot. In individuals with an accessory navicular, an additional piece of bone or cartilage is found adjacent to the main navicular bone. This extra bone can vary in size and shape, ranging from a small sesamoid bone to a larger bony prominence.

The presence of an accessory navicular does not always cause symptoms or problems. However, in some cases, it can lead to foot pain, particularly during activities that involve standing, walking, or running. The pain is often localized to the inside of the foot, near the midfoot or arch area.

The most common symptoms associated with an accessory navicular include:

  1. Pain and tenderness on the inside of the foot, especially during physical activities or when wearing tight or restrictive footwear.
  2. Swelling or redness around the area of the accessory navicular.
  3. Difficulty wearing certain types of shoes, especially those that compress the midfoot region.

Treatment for an accessory navicular typically depends on the presence and severity of symptoms. Non-surgical treatment options may include:

  1. Rest and Activity Modification: Avoiding or modifying activities that exacerbate pain and provide adequate rest for the foot to heal.
  2. Footwear Modifications: Wearing shoes that provide proper support, cushioning, and room for the foot to accommodate the accessory navicular.
  3. Orthotic Devices: Custom orthotic inserts or arch supports may be prescribed to provide additional support and relieve pressure on the affected area.
  4. Immobilization: In some cases, immobilization through the use of a cast or walking boot may be recommended to allow the foot to rest and heal.
  5. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended to alleviate pain and reduce inflammation.

If conservative treatments fail to provide relief or if the symptoms are severe, surgical intervention may be considered. Surgery typically involves removing the accessory bone or correcting any associated structural abnormalities. The specific surgical procedure will depend on the individual’s condition and the surgeon’s assessment.

If you suspect you have an accessory navicular or are experiencing foot pain, it is advisable to consult with a healthcare professional, such as a podiatrist or orthopedic specialist. They can evaluate your symptoms, perform diagnostic tests, and recommend appropriate treatment options based on your specific situation.


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