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Overview<br>The accessory navicular is an ossicle, or extra bone located medially to the navicular. Depending on the type, or stage, it may be connected to the navicular by a fibrous union, via a type of joint called a synchrondrosis. In those who have this extra bone, it is present at birth, but it starts as soft cartilage and then begins to ossify (turn into bone) at around age nine. Some sources believe that, in about half of those who have it, the bone will fuse to the navicular in late adolescence, but it is not clear that this actually happens.<br><br><br><br>Causes<br>This can result from any of the following. Trauma, as in a foot or ankle sprain. Chronic irritation from shoes or other footwear rubbing against the extra bone. Excessive activity or overuse. Many people with accessory navicular syndrome also have flat feet (fallen arches). Having a flat foot puts more strain on the posterior tibial tendon, which can produce inflammation or irritation of the accessory navicular.<br><br>Symptoms<br>Many people have accessory (?extra?) naviculars (figure 1) - a prominent extra bone extending from the navicular bone. Most accessory naviculars are completely asymptomatic. However, some individuals will develop pain on the inside of their midfoot. Pain may occur from the pressure of the shoe ware against the prominence, irritating either the bone itself or the fibrous junction where the accessory bone meets the regular navicular. Alternatively, the fibrous junction or interface may become painful as a result of tension applied by the posterior tibial tendon through its connection or insertion at that site. Often, individuals will be asymptomatic for years, however, a new pair of shoes or a change in their activity level can cause symptoms. The accessory navicular itself typically develops during adolescence, when the two areas of the navicular bone fail to fuse together.<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://Simsiamszkrxza.Hazblog.com/ heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>Traditional medicine often falls short when it comes to treatment for this painful condition. As similar to other chronic pain conditions, the following regimen is usually recommended: RICE, immobilization, anti-inflammatory medications, cortisone injections, and/or innovative surgical options. Clients familiar with Prolotherapy often say? no thanks? to those choices, as they know these treatments will only continue to weaken the area in the foot. Instead, they choose Prolotherapy to strengthen the structures in the medial foot.<br><br><br><br>Surgical Treatment<br>If conservative measures do not seem to help, however, you may need to have surgery to make adjustments to the bump. This could include reshaping the little bone, repairing damage to the posterior tibial tendon, or even removing the accessory navicular altogether.
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Overview<br>Sometimes, feet do weird things. For instance, about 10% of the general population?s feet have decided that having an extra bone in the mix is a  really great idea. This extra bone (or sometimes a bit of cartilage), is called an accessory navicular. It shows up in a tendon called the posterior tibial tendon (which is a fancy name - but just remember, it helps support the arch of the foot) on the middle of the inside of the foot, just above the arch. This extra little bone is present from birth, so it?s not something that?ll suddenly grow later in life. Now, accessory navicular syndrome is when that extra bone starts causing issues with your shoe-wearing, or even the shape and function of your foot. It?s the syndrome you want to worry about, not necessarily the extra bone itself.<br><br><br><br>Causes<br>People who have an accessory navicular often are unaware of the condition if it causes no problems. However, some people with this extra bone develop a painful condition known as accessory navicular syndrome when the bone and/or posterior tibial tendon are aggravated. This can result from any of the following. Trauma, as in a foot or ankle sprain. Chronic irritation from shoes or other footwear rubbing against the extra bone. Excessive activity or overuse.<br><br>Symptoms<br>What are the signs/symptoms of Accessory Navicular Syndrome? Pain in the foot following trauma (such as after an ankle sprain) Chronic irritation from shoes or other footwear rubbing against the bone. A visible bony prominence on the inner side of the foot just above the arch. Redness and swelling of that area. Vague pain or throbbing in the arch mostly occuring during or after periods of physical activity. Symptoms appear most often during adolescence, but some may not occur until adulthood.<br><br>Diagnosis<br>An initial assessment is an orthopaedic office begins with a thorough history and complete physical exam, including an assessment of the posterior tibial tendon and areas of tenderness. Associated misalignments of the ankle and foot should be noted. Finally, weight-bearing x-rays of the foot will help in making the diagnosis. Sometimes, an MRI may be needed to see if the posterior tibial tendon is involved with the symptoms or getting more clarity on the anatomy of the accessory navicular.<br><br>Non Surgical Treatment<br>Aside from surgery, there are a few options for handling an accessory navicular bone that has become symptomatic. This includes immobilization, icing, medicating, physical therapy, and orthotic devices. Immobilizing involves placing the foot and ankle in a cast or removable walking boot. This alleviates stressors on the foot and can [https://www.b2bmarketing.net/search/gss/decrease%20inflammation decrease inflammation]. Icing will help reduce swelling and inflammation. Medication involves usage of nonsteroidal anti-inflammatory drugs, or steroids (taken orally or injected) to decrease inflammation. Physical therapy [http://vernellnalty.eklablog.com/rss/ How can you heal an Achilles tendonitis fast?] be prescribed in order to strengthen the muscles and help decrease inflammation. Physical therapy can also help prevent the symptoms from returning. Orthotic devices (arch support devices that fit in a shoe) can help prevent future symptoms. Occasionally, the orthotic device will dig into the edge of the accessory navicular and cause discomfort. For this reason, the orthotic devices made for the patient should be carefully constructed.<br><br><br><br>Surgical Treatment<br>After the anesthesia is administered you will be heavily sedated and placed on your stomach. Surgeons will place a tourniquet around your thigh and an incision will be made on the inside of the foot. The posterior tibial tendon will be moved as necessary and the accessory navicular will be removed. Surgeons will repair the posterior tibial tendon with sutures or suture anchors, and the wound will be closed. A splint will be placed on the foot for stabilization and immobilization. You will be permitted to leave the surgical center once you have been cleared by the anesthesiologist. Plan ahead to have a friend or family member take your prescription to a pharmacy to pick up your post-op medication. Use narcotic pain medications before bed or if numbness in your foot begins to dull. Schedule a post-op visit for 4 weeks after the procedure.

Revisión de 13:17 16 jul 2017

Overview
Sometimes, feet do weird things. For instance, about 10% of the general population?s feet have decided that having an extra bone in the mix is a really great idea. This extra bone (or sometimes a bit of cartilage), is called an accessory navicular. It shows up in a tendon called the posterior tibial tendon (which is a fancy name - but just remember, it helps support the arch of the foot) on the middle of the inside of the foot, just above the arch. This extra little bone is present from birth, so it?s not something that?ll suddenly grow later in life. Now, accessory navicular syndrome is when that extra bone starts causing issues with your shoe-wearing, or even the shape and function of your foot. It?s the syndrome you want to worry about, not necessarily the extra bone itself.



Causes
People who have an accessory navicular often are unaware of the condition if it causes no problems. However, some people with this extra bone develop a painful condition known as accessory navicular syndrome when the bone and/or posterior tibial tendon are aggravated. This can result from any of the following. Trauma, as in a foot or ankle sprain. Chronic irritation from shoes or other footwear rubbing against the extra bone. Excessive activity or overuse.

Symptoms
What are the signs/symptoms of Accessory Navicular Syndrome? Pain in the foot following trauma (such as after an ankle sprain) Chronic irritation from shoes or other footwear rubbing against the bone. A visible bony prominence on the inner side of the foot just above the arch. Redness and swelling of that area. Vague pain or throbbing in the arch mostly occuring during or after periods of physical activity. Symptoms appear most often during adolescence, but some may not occur until adulthood.

Diagnosis
An initial assessment is an orthopaedic office begins with a thorough history and complete physical exam, including an assessment of the posterior tibial tendon and areas of tenderness. Associated misalignments of the ankle and foot should be noted. Finally, weight-bearing x-rays of the foot will help in making the diagnosis. Sometimes, an MRI may be needed to see if the posterior tibial tendon is involved with the symptoms or getting more clarity on the anatomy of the accessory navicular.

Non Surgical Treatment
Aside from surgery, there are a few options for handling an accessory navicular bone that has become symptomatic. This includes immobilization, icing, medicating, physical therapy, and orthotic devices. Immobilizing involves placing the foot and ankle in a cast or removable walking boot. This alleviates stressors on the foot and can decrease inflammation. Icing will help reduce swelling and inflammation. Medication involves usage of nonsteroidal anti-inflammatory drugs, or steroids (taken orally or injected) to decrease inflammation. Physical therapy How can you heal an Achilles tendonitis fast? be prescribed in order to strengthen the muscles and help decrease inflammation. Physical therapy can also help prevent the symptoms from returning. Orthotic devices (arch support devices that fit in a shoe) can help prevent future symptoms. Occasionally, the orthotic device will dig into the edge of the accessory navicular and cause discomfort. For this reason, the orthotic devices made for the patient should be carefully constructed.



Surgical Treatment
After the anesthesia is administered you will be heavily sedated and placed on your stomach. Surgeons will place a tourniquet around your thigh and an incision will be made on the inside of the foot. The posterior tibial tendon will be moved as necessary and the accessory navicular will be removed. Surgeons will repair the posterior tibial tendon with sutures or suture anchors, and the wound will be closed. A splint will be placed on the foot for stabilization and immobilization. You will be permitted to leave the surgical center once you have been cleared by the anesthesiologist. Plan ahead to have a friend or family member take your prescription to a pharmacy to pick up your post-op medication. Use narcotic pain medications before bed or if numbness in your foot begins to dull. Schedule a post-op visit for 4 weeks after the procedure.

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