An Accessory Navicular is an extra piece of bone on the medial side of the navicular bone that can become painful and can affect the biomechanics of the foot.
The accessory navicular is an extra bone or piece of cartilage located on the inner side of the foot, just above the arch. It’s situated next to the navicular bone, one of the key bones in the midfoot, and often within the posterior tibial tendon, which supports the arch. Not everyone has this accessory bone—it’s considered a congenital anomaly and is present in approximately 10–15% of the population. While it’s often asymptomatic, its presence can become clinically significant, particularly in individuals who are very active or who have flat feet.
There are three types of accessory naviculars, each with different clinical implications. Type I is a small, round sesamoid bone embedded in the posterior tibial tendon, usually asymptomatic. Type II is the most common and most likely to cause symptoms—it’s a triangular or heart-shaped bone connected to the navicular by cartilage or fibrous tissue, which can irritate the tendon and cause pain, especially during adolescence or increased activity. Type III is essentially a fused Type II, forming an enlarged navicular bone that may still be painful due to altered biomechanics. These distinctions are crucial for determining the best management approach.
When symptomatic, accessory navicular syndrome typically presents with pain and swelling on the inner foot, especially during or after physical activity. Treatment often starts conservatively—with rest, ice, arch supports or orthotics, physical therapy, and possibly immobilization. In persistent or severe cases, particularly with a symptomatic Type II accessory navicular, surgical intervention might be considered. This can involve removal of the accessory bone and realignment or reinforcement of the posterior tibial tendon. Proper diagnosis via imaging (X-ray, MRI, or CT) is key to developing a targeted treatment plan.
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A is for Accessory Navicular Acessory Navicular
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Classification of the Accessory Navicular Acessory Navicular https://foothealthguide.net/accessory-navicular-clinical-overview-and-management/
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Classification of the Accessory Navicular