Foot Osteochondroses, Sports Medicine

Accessory navicular: unfused accessory ossification center at posterior tibialis tendon (PTT) insertion

Geist classification:

• Type I: small sesamoid bone in PTT (usually 2 to 3 mm)

• Type...

Accessory navicular:

• Symptomatic or asymptomatic

• Most often clinically relevant accessory navicular is symptomatic type II.

Köhler disease:

• Based on history and x-ray findings

• Does not equal asym...

Accessory navicular:

• Rest, shoe insert/orthotic (soft orthotic initially until pain free and then assess mechanics to see if semirigid orthotic is better for longer term suppo...

Accessory navicular:

• Most do not become painful.

• Painful lesions in adolescents often improve with growth.

• Uncertain prognosis for symptomatic lesion treated nonoperatively

• Continued...

Canale ST, Williams KD. Iselin’s disease. J Pediatr Orthop.  1992;12(1):90–93.

Keles-Celik N, Kose O, Sekerci R, et al. Accessory ossicles of the foot and ankle: disorders and a...

Symptomatic type II accessory navicular may respond less favorably to conservative treatment in adolescent athletes.

Asymptomatic radiologic abnormalities without pain or antalgic gait ...