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Overview<br>An accessory navicular bone is an accessory bone of the foot that occasionally develops abnormally causing a plantar medial enlargement of the navicular. The accssory navicular bone presents as a sesamoid in the posterior tibial tendon, in articulation with the navicular or as an enlargment of the navicular. Navicular (boat shaped) is an intermediate tarsal bone on the medial side of the foot. It is located on the medial side of the foot, and articulates proximally with the talus. Distally it articulates with the three cuneiform bones. In some cases it articulates laterally with the cuboid. The tibialis posterior inserts to the os naviculare. The tibialis posterior muscle also contracts to produce inversion of the foot and assists in the plantar flexion of the foot at the ankle. Tibialis posterior also has a major role in supporting the medial arch of the foot. This supports is compromised by abnormal insertion of the tendon into the accessory navicular bone when present. This lead to loss of suspension of tibialis posterior tendon and may cause peroneal spastic pes planus or simple pes planus. But, yet a cause and effect relationship between the accessory navicular and pes planus is doubtful and is yet unproved clearly.<br><br><br><br>Causes<br>Most of the time, this condition is asymptomatic and people may live their whole lives unaware that they even have this extra bone. The main reason the accessory navicular bone becomes problematic is when pain occurs. There is no need for intervention if there is no pain. The accessory navicular bone is easily felt in the medial arch because it forms a bony prominence there. Pain may occur if the accessory bone is overly large causing this bump on the instep to rub against footwear.<br><br>Symptoms<br>Most people born with this bone begin to experience the symptoms (if at all any) in adolescence. Some may not develop any symptoms until adulthood. The symptoms are a visible abnormal protrusion in the mid-foot, swelling and redness of the protrusion, pain in the mid-foot after performing an activity.<br><br>Diagnosis<br>To diagnose accessory navicular syndrome, medical staff ask about the patient?s activities and symptoms. They will examine the foot for irritation or swelling. Medical staff  evaluate the bone structure, muscle, joint motion, and the patient?s gait. X-rays can usually confirm the diagnosis. MRI or other imaging tests may be used to determine any irritation or damage to soft-tissue structures such as tendons or ligaments. Because navicular accessory bone irritation can lead to bunions, [http://mercifulruffian38.soup.io/post/594544081/Hammer-Toe-Cause-And-Treatment heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>Treating accessory navicular syndrome is focused on relieving symptoms. Some treatment methods are Icing to reduce swelling. Immobilization with a cast or walking boot to reduce inflammation and promote healing. Medications to reduce pain and inflammation. Physical therapy to strengthen muscles. Orthotics to support the arch. Surgery may be needed to remove the accessory bone and reshape the area if other methods are not successful.<br><br><br><br>Surgical Treatment<br>In the original Kidner procedure, the entire posterior tibial tendon was released from the navicular and then rerouted through a drill hole placed through the navicular. The original Kidner procedure is now rarely used as a means of treating an isolated accessory navicular. Instead, a modification of the Kidner procedure has become more commonplace. The modified Kidner procedure consists of carefully removing the accessory and anchoring the posterior tibial tendon to the surface of the navicular where the accessory was removed. The repair may be done by passing a suture through the tendon and then through drill holes in the navicular, or by using a suture anchor.
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Overview<br>This syndrome is also referred to as os tibial naviculare or os tibial externum. As stated above, this condition quite often does not cause any pain. But if the posterior tibial tendon (the extra bone attaches to this tendon in the foot) or the accessory navicular bone itself were to get aggravated, then there would be pain.<br><br><br><br>Causes<br>The syndrome may result from any of the following, previous trauma such as a foot or ankle sprain. Chronic irritation from shoes or other footwear causing friction against the bone. Strain from overuse or excessive activity.<br><br>Symptoms<br>Adolescence is a common time for the symptoms to first appear. This is a time when bones are maturing and cartilage is developing into bone. Sometimes, however, the symptoms do not occur until adulthood. The signs and symptoms of accessory navicular syndrome include a visible bony prominence on the midfoot (the inner side of the foot, just above the arch) Redness and swelling of the bony prominence, Vague pain or throbbing in the midfoot and arch, usually occurring during or after periods of activity.<br><br>Diagnosis<br>To diagnose accessory navicular syndrome, medical staff ask about the patient?s activities and symptoms. They will examine the foot for [http://www.recruitingblogs.com/main/search/search?q=irritation irritation] or swelling. Medical staff  evaluate the bone structure, muscle, joint motion, and the patient?s gait. X-rays [http://geraldbohmer.jimdo.com Can you increase your height by stretching?] usually [http://rt.com/search/everywhere/term/confirm/ confirm] the diagnosis. MRI or other imaging tests may be used to determine any irritation or damage to soft-tissue structures such as tendons or ligaments. Because navicular accessory bone irritation can lead to bunions, heel spurs and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>The goal of non-surgical treatment for accessory navicular syndrome is to relieve the symptoms. The following may be used. Placing the foot in a cast or removable walking boot allows the affected area to rest and decreases the inflammation. To reduce swelling, a bag of ice covered with a thin towel is applied to the affected area. Do not put ice directly on the skin. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed. In some cases, oral or injected steroid medications may be used in combination with immobilization to reduce pain and inflammation. Physical therapy may be prescribed, including exercises and treatments to strengthen the muscles and decrease inflammation. The exercises may also help prevent recurrence of the symptoms. Custom orthotic devices that fit into the shoe provide support for the arch, and may play a role in preventing future symptoms. Even after successful treatment, the symptoms of accessory navicular syndrome sometimes reappear. When this happens, non-surgical approaches are usually repeated.<br><br><br><br>Surgical Treatment<br>If non-surgical treatment fails to relieve the symptoms of accessory navicular syndrome, surgery may be appropriate. Surgery may involve removing the accessory bone, reshaping the area, and repairing the posterior tibial tendon to improve its function. This extra bone is not needed for normal foot function.

Última revisión de 02:33 16 jul 2017

Overview
This syndrome is also referred to as os tibial naviculare or os tibial externum. As stated above, this condition quite often does not cause any pain. But if the posterior tibial tendon (the extra bone attaches to this tendon in the foot) or the accessory navicular bone itself were to get aggravated, then there would be pain.



Causes
The syndrome may result from any of the following, previous trauma such as a foot or ankle sprain. Chronic irritation from shoes or other footwear causing friction against the bone. Strain from overuse or excessive activity.

Symptoms
Adolescence is a common time for the symptoms to first appear. This is a time when bones are maturing and cartilage is developing into bone. Sometimes, however, the symptoms do not occur until adulthood. The signs and symptoms of accessory navicular syndrome include a visible bony prominence on the midfoot (the inner side of the foot, just above the arch) Redness and swelling of the bony prominence, Vague pain or throbbing in the midfoot and arch, usually occurring during or after periods of activity.

Diagnosis
To diagnose accessory navicular syndrome, medical staff ask about the patient?s activities and symptoms. They will examine the foot for irritation or swelling. Medical staff evaluate the bone structure, muscle, joint motion, and the patient?s gait. X-rays Can you increase your height by stretching? usually confirm the diagnosis. MRI or other imaging tests may be used to determine any irritation or damage to soft-tissue structures such as tendons or ligaments. Because navicular accessory bone irritation can lead to bunions, heel spurs and plantar fasciitis, it?s important to seek treatment.

Non Surgical Treatment
The goal of non-surgical treatment for accessory navicular syndrome is to relieve the symptoms. The following may be used. Placing the foot in a cast or removable walking boot allows the affected area to rest and decreases the inflammation. To reduce swelling, a bag of ice covered with a thin towel is applied to the affected area. Do not put ice directly on the skin. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed. In some cases, oral or injected steroid medications may be used in combination with immobilization to reduce pain and inflammation. Physical therapy may be prescribed, including exercises and treatments to strengthen the muscles and decrease inflammation. The exercises may also help prevent recurrence of the symptoms. Custom orthotic devices that fit into the shoe provide support for the arch, and may play a role in preventing future symptoms. Even after successful treatment, the symptoms of accessory navicular syndrome sometimes reappear. When this happens, non-surgical approaches are usually repeated.



Surgical Treatment
If non-surgical treatment fails to relieve the symptoms of accessory navicular syndrome, surgery may be appropriate. Surgery may involve removing the accessory bone, reshaping the area, and repairing the posterior tibial tendon to improve its function. This extra bone is not needed for normal foot function.