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Overview<br>Sometimes, feet do weird things. For instance, about 10% of the general population?s feet have decided that having The accessory navicular (os navicularum or os tibiale externum) is an extra bone in the mix is a really great idea. This extra bone (or sometimes a bit piece of cartilage), is called an accessory navicular. It shows up in a tendon called the posterior tibial tendon (which is a fancy name - but just remember, it helps support the arch of the foot) located on the middle of the inside inner side of the foot, just above the arch. This extra little bone It is incorporated within the posterior tibial tendon, which attaches in this area. An accessory navicular is congenital (present from at birth, so it?s ). It is not part of normal bone structure and therefore is not something that?ll suddenly grow later present in lifemost people. NowPeople 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 is when that extra the bone starts causing issues and/or posterior tibial tendon are aggravated. Many people with your shoe-wearingaccessory 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 even the shape and function irritation of your foot. It?s the syndrome you want to worry about, not necessarily the extra bone itselfaccessory navicular.<br><br><br><br>Causes<br>An accessory Accessory navicular develops syndrome as it is called can result from a result number of a congenital anomaly and is found more often causes, excess or overuse syndrome as seen in an athlete. Trauma to the foot as in womenan ankle sprain or direct trauma to the navicular bone. If chronic irritation from shoes rubbing against the extra bone is large, it over time, may rub against a shoe, causing cause pain. Because Excessive pronation which strains the attachment of its location, the tibialis posterior tibial tendon may pull on muscles into the navicular bone during walking or running. Keep in mind, causing the fibrous tissue that connects larger the actual accessory navicular to bone, the greater the navicular to tear and become inflamedchance of it becoming an issue.<br><br>Symptoms<br>Symptoms of Most people born with this syndrome would include redness, swelling and tenderness over bone begin to experience the navicular bonesymptoms (if at all any) in adolescence. Some may not develop any symptoms until adulthood. The navicular bone is located on symptoms are a visible abnormal protrusion in the inside mid-foot, swelling and redness of the protrusion, pain in the mid-foot approximately midway between the ankle bone and big toe joint. It will tend to be worse after performing an activity and can be aggravated by those that wear very dressy shoes as opposed to casual shoes like sneakers. In other words, the flatter or less supportive the shoe, the greater the chance for pain.<br><br>Diagnosis<br>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, [http://lavonne0blevins58nosyalloy820.wordpresssoup.com/2015io/06post/22594916943/doHammer-hammertoeToes-splintsWhat-do-theCauses-job Them heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>The initial goal of non-surgical treatment approach for accessory navicular syndrome is non-operativeto relieve the symptoms. An orthotic The following may be recommended used. Placing the foot in a cast or removable walking boot allows the affected area to rest and decreases the patient may undergo inflammation. To reduce swelling, a brief period bag of casting ice covered with a thin towel is applied to rest the footaffected area. Do not put ice directly on the skin. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed. For chronic In some cases, oral or injected steroid medications may be used in combination with immobilization to reduce painand inflammation. Physical therapy may be prescribed, however, including exercises and treatments to strengthen the muscles and decrease inflammation. The exercises may also help prevent recurrence of the orthopedic surgeon removes symptoms. Custom orthotic devices that fit into the extra boneshoe provide support for the arch, a relatively simple surgery with a brief rehabilitation period and may play a very good success raterole 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.<br><br><br><br>Surgical Treatment<br>For patients who have failed conservative care or who have had recurrent If non-operative treatment fails to relieve the patient’s symptoms, surgery can surgical intervention may be consideredwarranted. Surgical intervention requires The standard operative treatment of an excision of the accessory navicular and reattachment of the posterior tibial tendon to the navicular. Often times, this is the only a Kidner procedure necessary. However, if there are other deformities such as a flat foot or forefoot surgery is undertaken it is important that is abducted, other procedures may be requiredit address the underlying source of the patients pain.