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      • Foot Drop
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        • Toe and Metatarsal Fractures (Broken Toes)
      • Gangrene
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      • Hallux Rigidus
      • Hammertoes
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      • Intermetatarsal Neuroma
      • Intoeing
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      • Joint Swelling in the Foot
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      • Osteoarthritis of the Foot and Ankle
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      • Posterior Tibial Tendon Dysfunction (PTTD)
      • R.I.C.E Protocol
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      • Rheumatoid Arthritis in the Foot and Ankle
      • Sesamoid Injuries in the Foot
      • Shin Splints
      • Swollen Feet
      • Synovitis
      • Tailor's Bunion
      • Talar Dome Lesion
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      • Plantar Wart (Verruca Plantaris)
      • Pump Bump (Hallux Rigidus)
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  • Home >
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  • Accessory Navicular Syndrome

AccesNav1What is the Accessory Navicular? 
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.  
 
What is Accessory Navicular Syndrome?
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

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.

Signs and Symptoms of Accessory Navicular Syndrome
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

AccesNav2Diagnosis
To diagnose accessory navicular syndrome, the foot and ankle surgeon will ask about symptoms and examine the foot, looking for skin irritation or swelling. The doctor may press on the bony prominence to assess the area for discomfort. Foot structure, muscle strength, joint motion, and the way the patient walks may also be evaluated.  

X-rays are usually ordered to confirm the diagnosis. If there is ongoing pain or inflammation, an MRI or other advanced imaging tests may be used to further evaluate the condition.

Treatment: Non-Surgical Approaches 
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.
  • Medications. 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. 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.
  • Orthotic devices. 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.

When Is Surgery Needed? 
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.

  • Bone/Joint/Tendon
    • Accessory Navicular Syndrome
    • Achilles Tendon Rupture
    • Ankle
      • Ankle Arthritis
      • Ankle Fractures
      • Ankle Pain
      • Ankle Sprain
      • Swollen Ankles
      • Tarsal Coalition
      • Tarsal Tunnel Syndrome
      • Weak Ankles
    • Arch Pain
    • Arch Supports
    • Bone Healing
    • Bone Infection
    • Bone Tumors in the Foot
    • Brachymetatarsia
    • Bunions (Hallux Abducto Valgus)
    • Bursitis
    • Calcaneal Apophysitis (Sever's Disease)
    • Calf Pain
    • Capsulitis of the Second Toe
    • Cavus Foot (High-Arched Foot)
    • Charcot Foot
    • Chronic Ankle Instability
    • Clubfoot
    • Cold Feet
    • Common Disorders of the Achilles Tendon
    • Drop Foot
    • DVT (Deep Vein Thrombosis)
    • Extra Bones
    • Fallen Arches
    • Fifth Metatarsal Fracture
    • Flatfoot
      • Flatfoot-Adult Acquired
      • Flatfoot-Flexible
      • Flatfoot-Pediatric
    • Foot Arthritis
    • Foot Drop
    • Fracture
      • Foot Fracture
      • Fracture-Ankle
      • Fracture-Foot
      • Fractures of the Calcaneus (Heel Bone Fractures)
      • Fractures of the Fifth Metatarsal
      • Fracture-Toe
      • Jones Fracture
      • Stress Fracture in the Foot
      • Toe and Metatarsal Fractures (Broken Toes)
    • Gangrene
    • Gout
    • Haglund's Deformity
    • Hallux Rigidus
    • Hammertoes
    • Heel Pain (Plantar Fasciitis)
    • High-Arched Foot
    • Intermetatarsal Neuroma
    • Intoeing
    • Joint Pain in the Foot
    • Joint Swelling in the Foot
    • Lisfranc Injuries
    • Os Trigonum Syndrome
    • Osteoarthritis of the Foot and Ankle
    • Osteomyelitis (Bone Infection)
    • Osteopenia
    • Osteoporosis
    • Peroneal Tendon Injuries
    • Pigeon-toes
    • Posterior Tibial Tendon Dysfunction (PTTD)
    • R.I.C.E Protocol
    • Restless Legs
    • Rheumatoid Arthritis in the Foot and Ankle
    • Sesamoid Injuries in the Foot
    • Shin Splints
    • Swollen Feet
    • Synovitis
    • Tailor's Bunion
    • Talar Dome Lesion
    • Tingly Feet
    • Tired Feet
    • Toe Walking
    • Turf Toe
    • Varicose Veins
    • Webbed Toes
  • Nails and Skin
    • Athlete's Foot
    • Black Toenails
    • Callus
    • Contact Dermatitis
    • Corns
    • Cracked Heels
    • Dermatitis
    • Dry Heels
    • Eczema of the Foot
    • Foot Bumps
    • Foot Lumps
    • Foot Odor
    • Foot Rash
    • Frostbite
    • Fungal Nails
    • Ganglion Cyst
    • Heel Fissures
    • Inflammation: Acute
    • Ingrown Toenails
    • Malignant Melanoma of the Foot
    • Plantar Fibroma
    • Plantar Wart (Verruca Plantaris)
    • Pump Bump (Hallux Rigidus)
    • Puncture Wounds
    • Rash
    • Raynauds Phenomenon
    • Skin Cancer of the Foot and Ankle
    • Smelly Feet
    • Sweaty Feet
    • Thick Toenails
    • Warts
    • White Toenails
    • Wounds/Ulcers
    • Wounds-Puncture
    • Yellow Toenails
  • Diabetic Health
    • Diabetic Complications and Amputation Prevention
    • Diabetic Foot Care Guidelines
    • Diabetic Peripheral Neuropathy
    • Diabetic Shoes
    • MRSA Infection of the Foot
    • Peripheral Arterial Disease (P.A.D.)
    • Soft Tissue Biopsy
  • Fitness and Your Feet
    • Baseball Injuries to the Foot and Ankle
    • Basketball Injuries to the Foot and Ankle
    • Field Hockey Injuries to the Foot and Ankle
    • Football Injuries to the Foot and Ankle
    • Golf Injuries to the Foot and Ankle
    • Lacrosse Injuries to the Foot and Ankle
    • Rugby Injuries to the Foot and Ankle
    • Running and Track Injuries to the Foot and Ankle
    • Soccer Injuries to the Foot and Ankle
    • Softball Injuries to the Foot and Ankle
    • Tennis Injuries to the Foot and Ankle
    • Volleyball Injuries to the Foot and Ankle
  • Orthotics and Footwear
    • Custom Orthotic Devices
    • Orthotics
    • Shoe Inserts
  • Compartment Syndrome
  • Deep Vein Thrombosis (DVT)
  • Equinus
  • Instructions for Using Crutches
  • Staph Infections of the Foot

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