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Overview<br>Some people have more bones in their feet than others. Actually, it?s not all that uncommon to have extra bones in the feet. These extra bones area called accessory bones. The navicular bone, one of the small bones located at the instep or arch of the middle of the foot, is an example of an extra bone people are born with. It?s called the accessory navicular bone. During the maturation process, the navicular and the accessory navicular never fuse into one solid bone, but remain connected by fibrous tissue or cartilage. It is estimated that 4-14% of the population are born with an accessory navicular bone.<br><br><br><br>Causes<br>Let us see the reasons why the tendon or the bone would get aggravated. Ankle or foot sprain, irritation of the bone caused by footwear, overusing the foot, quite common in athletes and dancers. People born with this extra bone are also known develop flat feet which also adds to the strain on the posterior tibial tendon and lead to the syndrome.<br><br>Symptoms<br>Symptoms of accessory navicular include. Bone lump on the inside of the foot. Redness and swelling. Pain.<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://penniferrari.weebly.com heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>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.<br><br><br><br>Surgical Treatment<br>The original procedure advocated by Kidner involved shelling out of the accessory navicular bone from within the insertional area of the posterior tibial tendon and rerouting this tendon under the navicular bone in hopes of restoring a normal pull of this tendon. When treating younger children, history has shown us that simply shelling out of the accessory navicular bone from within the tendon and remodeling the tuberosity of the navicular bone can give you satisfactory results.<br>In general, you want to reserve advancement of the posterior tibial tendon for adults or those who have a more significant flatfoot deformity. You may also use this approach after determining that quality custom orthotics are only resulting in a slight decrease of symptoms.
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Overview<br>The accessory navicular (os navicularum or os tibiale externum) is an extra bone or piece of cartilage located on the inner side of the foot just above the arch. It is incorporated within the posterior tibial tendon, which attaches in this area. An accessory navicular is congenital (present at birth). It is not part of normal bone structure and therefore is not present in most people.<br><br><br><br>Causes<br>Accessory navicular syndrome as it is called can result from a number of causes, excess or overuse syndrome as seen in an athlete. Trauma to the foot as in an ankle sprain or direct trauma to the navicular bone. chronic irritation from shoes rubbing against the extra bone, over time, may cause pain. Excessive pronation which strains the attachment of tibialis posterior muscles into the navicular bone. Keep in mind, the larger the actual accessory bone, the greater the chance of it becoming an issue.<br><br>Symptoms<br>The catalyst for symptoms might be some sort of injury (such as a broken or sprained ankle), excessive activity, or irritation from where shoes are rubbing on the bony prominence the accessory navicular makes. These can irritate the bone, or make the tendon it?s embedded in (the posterior tibial tendon, remember?) inflamed and sore. Because the tendon is compromised in its ability to support the arch, accessory navicular syndrome almost always leads to flat feet, which is one very obvious symptom.<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://Zelmafoston.wordpress.com/2015/06/22/hammertoe-pain-treatment 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. Immobilization. Placing the foot in a cast or removable walking boot allows the affected area to rest and decreases the inflammation. Ice. 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. Oral 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 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.

Última revisión de 01:20 12 jun 2017

Overview
The accessory navicular (os navicularum or os tibiale externum) is an extra bone or piece of cartilage located on the inner side of the foot just above the arch. It is incorporated within the posterior tibial tendon, which attaches in this area. An accessory navicular is congenital (present at birth). It is not part of normal bone structure and therefore is not present in most people.



Causes
Accessory navicular syndrome as it is called can result from a number of causes, excess or overuse syndrome as seen in an athlete. Trauma to the foot as in an ankle sprain or direct trauma to the navicular bone. chronic irritation from shoes rubbing against the extra bone, over time, may cause pain. Excessive pronation which strains the attachment of tibialis posterior muscles into the navicular bone. Keep in mind, the larger the actual accessory bone, the greater the chance of it becoming an issue.

Symptoms
The catalyst for symptoms might be some sort of injury (such as a broken or sprained ankle), excessive activity, or irritation from where shoes are rubbing on the bony prominence the accessory navicular makes. These can irritate the bone, or make the tendon it?s embedded in (the posterior tibial tendon, remember?) inflamed and sore. Because the tendon is compromised in its ability to support the arch, accessory navicular syndrome almost always leads to flat feet, which is one very obvious symptom.

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 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. Immobilization. Placing the foot in a cast or removable walking boot allows the affected area to rest and decreases the inflammation. Ice. 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. Oral 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 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.