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Accessory Navicular Syndrome

We treat patients for many different conditions here at our Austin, TX podiatrist office. There are some foot and ankle issues that we see on a frequent basis. Issues like plantar fasciitis, fungal toenails, and sprained ankles are rather common. On the other end of the spectrum, we are also able to provide expert care for lesser-known problems like accessory navicular syndrome.

What is the Accessory Navicular? 

The accessory navicular is an extra bone that can sometimes be found on the inside edge of the foot, just above the arch. It is typically present at birth (congenital) and incorporated within a tendon (posterior tibial) that attaches in the area. Not a part of the normal skeletal system, this bone is only present in a small percentage of the general population.

What is Accessory Navicular Syndrome?

Most of the individuals with this extra bone are unaware of it, especially if the accessory navicular is not causing any issues. Some of those with this congenital abnormality, however, develop particular set of symptoms when the posterior tibial tendon or bone tissue is aggravated in some manner.

Potential causes of this condition include:

  • Overuse or excessive physical activity
  • Trauma, such as a foot or ankle sprain
  • Chronic irritation when shoes or other types of footwear rub against the extra bone

Most individuals who have accessory navicular issues also have fallen arches (flat feet). This might be explained by the fact that a flat foot will lead to excessive strain being placed on the posterior tibial tendon.

Symptoms and Signs

For individuals affected by this issue, symptoms can begin during adolescence. At this particular time in physical development, bones mature and cartilage tissues can develop into bone. In some cases, symptoms do not develop until adulthood.

The symptoms and signs of accessory navicular syndrome include:

  • A visible bony prominence on the inner side of the foot, just above the arch (the midfoot)
  • Swelling and redness of the bony prominence
  • Vague throbbing and pain in the arch and midfoot, usually experienced during or after periods of activity

Diagnosis

When diagnosing this particular condition, our foot doctors will often examine the foot and look for swelling or skin irritation while asking about the nature of symptoms being experienced. Our specialists may gently press on the bony protrusion to evaluate and assess the discomfort present in the area. Muscle strength, foot structure, joint motion, and the patient’s gait pattern might also be evaluated.

In most cases, we may order X-rays or advanced imaging tests to confirm the diagnosis.

Non-Surgical Treatment Options

When using conservative, nonsurgical treatment options for this condition, the goal is essentially to relieve painful symptoms. Our treatment plan might include:

  • Immobilization. We can give the affected area an opportunity to rest and allow the inflammation to subside by having you use a removable walking boot or placing your foot in a cast.
  • Medications. We may choose to prescribe oral nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen. For some patients, this may be done in conjunction with steroid injections to reduce inflammation and painful symptoms.
  • Physical therapy. Physical therapy can be an effective option for not only strengthening supportive muscles and decreasing inflammation, but also in preventing the recurrence of symptoms.
  • Orthotic devices. Custom orthotic devices fit into your footwear and provide support for the arch, which can help prevent future symptoms.
  • Ice. To reduce swelling, we make recommend an icing regimen.

Surgery

Our hope will always be to alleviate painful symptoms through the use of conservative treatment methods, but surgery can be an option for this condition. We may recommend removing the accessory navicular (since it is not necessary for normal foot function) or repairing the posterior tibial tendon to improve function.

The First Choice for Foot Care in Austin, TX

Accessory navicular syndrome is one of many foot and ankle conditions we effectively treat for our patients here at Austin Foot and Ankle Specialists. When you want to experience true excellence in podiatry, be sure to schedule your appointment with us by calling (512) 328-8900 or accessing our convenient online form.

Dr. Craig H. Thomajan, DPM, FACFAS, FAENS
Founder and Managing Partner of Austin Foot and Ankle Specialists