Accessory navicular syndrome is the painful condition caused by the presence of the accessory navicular. Well, is the statement a bit confusing? Let me explain. The accessory navicular is a bone in the foot that is not supposed to be present. But in some very rare cases, this extra bone (sometimes can also be a cartilage piece) is present by birth. This bone exists in the arch of the foot. The presence of this bone though not common, is not abnormal either as most people are not even aware of its existence unless and until it begins to cause pain which we call accessory navicular syndrome.
An accessory navicular develops as a result of a congenital anomaly and is found more often in women. If the bone is large, it may rub against a shoe, causing pain. Because of its location, the posterior tibial tendon may pull on the bone during walking or running, causing the fibrous tissue that connects the accessory navicular to the navicular to tear and become inflamed.
The symptoms of accessory navicular syndrome commonly arise during adolescence, when bones are maturing and cartilage fuses into bone. In other instances, symptoms do not appAccessory Navicularear until adulthood. The signs and symptoms include a visible bony prominence on the midfoot the inner side of the foot above the arch. Redness or swelling of the bony prominence. Indistinct pain or throbbing in the midfoot and arch during or after physical activity.
Diagnosis starts by speaking with the patient about symptoms. The physician will look at the foot and examine it for signs of an accessory navicular. By putting pressure on the area, the doctor may determine its presence simply by the presence of pain. The muscle, joint, and the overall structure of the foot may be considered, as well as the way in which the patient walks. If a diagnosis of accessory navicular syndrome is made, an X-ray or MRI may be ordered to confirm diagnosis.
Non Surgical Treatment
Fortunately, surgery is not the only answer when it comes to relieving symptoms of accessory navicular syndrome. The physician may recommend wearing a cast or walking boot for a period of time so the foot can recover from the inflammation. Ice may be used to relieve swelling, too, although it should be wrapped to avoid direct contact with the skin.
The Kidner procedure involves resecting the prominent accessory navicular and ensuring that the posterior tibial tendon is still attached to the bone. Often the prominent bone can simply be shelled out from its position relative to the posterior tibial tendon, which leaves the tendon intact. However, if the tendon is loose and floppy once the extra bone has been removed, suturing or tother is required as a means of attaching it into the remaining navicular bone.