Accessory Navicular

What is Accessory Navicular?

On the inside of your foot, at the highest point of your arch is the approximate the location of your navicular.  It is an important bone in your foot as several tendons pass and insert into it.  An accessory navicular is an extra piece of bone or model of cartilage that is imbedded in the tendon of muscle which attaches to the navicular.

How did I get it?

It is not normally present at birth and therefore, is not present in everyone.  An accessory navicular can become a problem during development as activity levels and the demands of the muscles and tendons increase. 

What are the symptoms?

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. Signs and symptoms can include:

• A visibly 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.

How is it diagnosed?

It is normally diagnosed through clinical examination.  Accessing the injury, movement and palpable pain will guide the clinician to an accurate diagnosis.  Plain X-rays are ordered to confirm the diagnosis.  If there is persistent swelling, pain and inflammation advanced imaging techniques such as MRI may be utilised. 

Possible treatments?

• Non-steroidal anti-inflammatories

• Rest, Ice, Compression & Elevation

• Decreased weight bearing

• Activity modification

• Immoblisation

• Padding and strapping

• Footwear Modifications

• Neuromuscular Needling

• Custom Orthotics

Prognosis:

Providing absolute compliance, most patients respond well to the conservative treatments listed above. Surgery is often used as the last resort for non-responsive cases.