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Overview<br>Everyone has one An accessory navicular bone: one is an accessory bone of the small bones foot that occasionally develops abnormally in front of the foot. A small number of people have a second small navicular bone or piece of cartilage located on ankle towards the inside of the foot just above the arch: both are simply called an "accessary navicular . This bone." It is located within may be present in approximately 2-14% of the posterior tibial tendon which attaches in this area. It general population and is easy to see as a "bumpusually asymptomatic." Most that have When it never have painis symptomatic, surgery may be necessary. If they get pain, we call Surgery can be performed at any age because it: "Accessary navicular bone syndromedoes not alter any other bones."<br><br><br><br>Causes<br>The syndrome may result from any Most of the followingtime, previous trauma such as this condition is asymptomatic and people may live their whole lives unaware that they even have this extra bone. The main reason the accessory navicular bone becomes problematic is when pain occurs. There is no need for intervention if there is no pain. The accessory navicular bone is easily felt in the medial arch because it forms a foot or ankle sprainbony prominence there. Chronic irritation from shoes or other footwear Pain may occur if the accessory bone is overly large causing friction this bump on the instep to rub against the bone. Strain from overuse or excessive activityfootwear.<br><br>Symptoms<br>One obvious problem with the This painful condition is called accessory navicular is that it may be large and stick out from the inside of the footsyndrome. This Accessory navicular syndrome (ANS) can cause it to rub against shoes significant pain in the mid-foot and so become quite painfularch, especially with activity. The fibrous connection between the accessory navicular Redness and the navicualarswelling may develop over this bony prominence, as well, is easy as extreme sensitivity to injure, also leading to painpressure. This is kind of like a fracture, and such injuries cause the bone Sometimes people may be unable to move around too easily, leading to pain with activity. When wear shoes because the connection between the bones area is injured in this way, the two bones do not always heal properly, so pain may continue unabatedtoo sensitive.<br><br>Diagnosis<br>To diagnose Plain x-rays are used to determine the size of the accessory navicular syndrome, medical staff ask about the patient?s activities and symptoms. They will examine the foot for irritation or swelling. Medical staff There are three main types of accessory navicular bones: evaluate a small bone embedded within the nearby posterior tibial tendon; a triangular shaped bone structure, muscle, joint motion, connected to the navicular by thick cartilage; and a large prominent navicular tuberosity thought to represent an accessory navicular that has fused to the patient?s gaitnavicular. X-rays can usually confirm If the status of the diagnosis. MRI posterior tibial tendon needs to be assessed or if other imaging tests problems are suspected, (ex. Navicular stress fracture) it may be used necessary to determine any perform an MRI. Although this is not considered routine, an MRI may be helpful in identifying the degree of irritation . An MRI would demonstrate fluid or damage to soft-tissue structures such edema that may accumulate in the bone as tendons or ligaments. Because navicular accessory bone a result of the irritation can lead to bunions, [http://Lilirichesin.Blogas.lt/date/2015/07 heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>The initial treatment approach Aside from surgery, there are a few options for handling an accessory navicular is nonbone that has become symptomatic. This includes immobilization, icing, medicating, physical therapy, and orthotic devices. Immobilizing involves placing the foot and ankle in a cast or removable walking boot. This alleviates stressors on the foot and can decrease inflammation. Icing will help reduce swelling and inflammation. Medication involves usage of nonsteroidal anti-operativeinflammatory drugs, or steroids (taken orally or injected) to decrease inflammation. An orthotic may Physical therapy can be recommended or prescribed in order to strengthen the muscles and help decrease inflammation. Physical therapy can also help prevent the patient may undergo symptoms from returning. Orthotic devices (arch support devices that fit in a brief period shoe) can help prevent future symptoms. Occasionally, the orthotic device will dig into the edge of casting to rest the footaccessory navicular and cause discomfort. For chronic pain, howeverthis reason, the orthopedic surgeon removes orthotic devices made for the extra bone, a relatively simple surgery with a brief rehabilitation period and a very good success ratepatient should be carefully constructed.<br><br><br><br>Surgical Treatment<br>If Depending upon the severity the nonoperative or conservative treatment should be maintained for at least 4-6 months before any surgical intervention. There are 2 surgeries that can be performed depending upon the condition and symptoms. First is simple surgical treatment fails excision. In this generally the accessory navicular along with its prominence is removed. In this procedure, skin incision is made dorsally to relieve the symptoms prominence of accessory navicular syndrome, surgery may be appropriate. Surgery may involve removing Bone is removed to the point [http://catinaturomsha.jigsy.com/entries/general/heel-discomfort-the-causes-warning-signs-and-therapy-choices Where is the Achilles heel?] the medial foot has no bony prominence over the accessory bonenavicular, reshaping between the head of the area, talus and first cuneiform. Symptoms are relieved in 90% of cases. Second is Kindler procedure. In this the ossicle and repairing navicular prominence is excised as in simple excision but along with the posterior tibial tendon advancement. Posterior tibial tendon is split and advanced along the medial side of foot to provide support to improve its functionlongitudinal arch. After surgery 4 week short leg cast, well moulded into the arch with the foot plantigrade is applied. Partial weight bearing till the 8th week and later full weight bearing is allowed. This extra bone When the cast is not needed for normal foot functionbeing removed can start building up the ROM to counter atrophy and other physical therapy treatment which include stretching and strengthening exercises.<br><br>Th1s1sanart1cl3s1te