Accessory Ossicle Navicular Treatment

Overview
Everyone has one navicular bone: one of the small bones of the foot. A small number of people have a second small navicular bone or piece of cartilage located on the inside of the foot just above the arch: both are simply called an "accessary navicular bone." It is located within the posterior tibial tendon which attaches in this area. It is easy to see as a "bump." Most that have it never have pain. If they get pain, we call it: "Accessary navicular bone syndrome."



Causes
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.

Symptoms
Symptoms of accessory navicular include. Bone lump on the inside of the foot. Redness and swelling. Pain.

Diagnosis
Typically, accessory navicular syndrome isn?t hard to diagnose. Our podiatrists will examine the lower limb and check the hard prominence, as well as use X-rays to confirm the presence of extra bone tissue. Other diagnostic images may be able to identify inflammation and specific damage to the midfoot. Depending on the severity of your discomfort, conservative measures may be enough to resolve the condition.

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 can 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
Surgery may be an option if non-surgical treatment does not decrease the symptoms of accessory navicular syndrome. Since this bone is not needed for the foot to function normally, Your surgeon may remove the accessory navicular, reshape the area, and repair the posterior tibial tendon for improved function.