Is Accessory Navicular Syndrome Dangerous

Overview
The accessory navicular is an extra piece of cartilage or bone on the inner side of the foot. It is found in about 10 percent of individuals and is present at birth. Many people who have an accessory navicular are never aware of it because they do not experience symptoms. However, aggravation of the accessory navicular or the posterior tibia tendon, which it is attached to, can develop as a result of trauma, irritation from shoes, and excessive overuse.



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
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.

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
If symptoms have been aggravated by an increase in activity level, backing off on activities in the short term can be helpful. The foot is subject to a lot of repetitive loading during walking, and therefore minimizing this force will often help symptoms to settle. After symptoms have settled, the activity level can then be gradually increased.



Surgical Treatment
If your pain and discomfort don’t go away with treatments like these, then it may be time to consider surgery. If you decide to go through with it, your surgeon will probably remove the accessory navicular once and for all, and will tighten up the posterior tibial tendon in order to make it better able to support your arch. You’ll probably have to wear a cast for a several weeks, and a brace for some months after that, but with patience, you may be able to say goodbye to your symptoms.