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15:50, 13. Jun. 2017 Overview<br>Accessary bone syndrome affects overpronators because of irritation in this area. Improper fitting shoes can also irritate the area. When pain becomes such that it changes running form or becomes intolerable, something needs to be done. Surgery alone without addressing causative factors is useless. Pain returns and new cartilage returns in the tendon, and the inflammation causes pain.<br><br><br><br>Causes<br>It is commonly believed that the posterior tibial tendon loses its vector of pull to heighten the arch. As the posterior muscle contracts, the tendon is no longer pulling straight up on the navicular but must course around the prominence of bone and first pull medially before pulling upward. In addition, the enlarged bones may irritate and damage the insertional area of the posterior tibial tendon, making it less functional. Therefore, the presence of the accessory navicular bone does contribute to posterior tibial dysfunction.<br><br>Symptoms<br>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.<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://zinalanzalotti.blogas.lt/?p=9&akst_action=share-this heel spurs] and plantar fasciitis, it?s important to seek treatment.<br><br>Non Surgical Treatment<br>Rest is the most important factor in relieving your pain. You may need to immobilize your foot to allow the affected tissues to rest enough that they can heal. Icing the area will help decrease any inflammation and swelling. Our staff may recommend anti-inflammatory medications as well. Most likely you will need to change your footwear-and possibly add orthotics-to accommodate your bony prominence and relieve strain in the midfoot. Sometimes physical therapy may be able to help strengthen tissues and prevent additional injuries.<br><br><br><br>Surgical Treatment<br>If non-operative treatment fails to relieve the patient’s symptoms, surgical intervention may be warranted. The standard operative treatment of an accessory navicular is a Kidner procedure. However, if surgery is undertaken it is important that it address the underlying source of the patients pain.