Accessory navicular: unfused accessory ossification center at posterior tibialis tendon (PTT) insertion
Type I: small sesamoid bone in PTT (usually 2 to 3 mm)
Symptomatic or asymptomatic
Most often clinically relevant accessory navicular is symptomatic type II.
Based on history and x-ray findings
Does not equal asym...
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...
Most do not become painful.
Painful lesions in adolescents often improve with growth.
Uncertain prognosis for symptomatic lesion treated nonoperatively
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 ...
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