Os supranaviculare

Case
A 50-year-old male coach presented with a twelve-month history of dorsal foot pain. He described a minor twisting injury to his foot around this time. This did not seem like a big problem initially. At the time of his clinic visit the pain had deteriorated to the point that he was unable to wear boots due to the pressure on his foot, had difficulty wearing any tight shoes and had dorsal foot pain while walking.

On examination the major findings were of localised tenderness over the dorsum of the navicular, a normal mid-foot range of motion and a normal gait.

Findings
The lateral x-ray image shows a well corticated ossicle related to the dorsal navicular consistent with an os supranaviculare. There is no other abnormality seen in the mid-foot. A subsequent CT scan shows that the os measures 7 x 7 x 12 mm. There is sclerosis and a small amount of subchondral lucency in the navicular adjacent to the ossicle. No fracture is identified within the navicular. The remainder of the mid-foot was unremarkable. An MRI was not conducted in this case but would be expected to show increased signal with in the os and related to the synchondrosis.

Discussion
As this patient had experienced prolonged pain in his foot, he elected to have the ossicle excised. This was done without complication. He was able to return to all normal activities about three months following his surgery.

The os supranaviculare is an accessory ossicle located at the proximal and dorsal aspect of the navicular. It is also known as a Pirie’s bone, talonavicular dorsale or dorsal navicular ossicle. It is a normal variant that is present in approximately 1% of the population. The ossicle may be fused with the talus or with the navicular bone and is generally held in place by a synchondrosis. In the majority of cases the ossicle is an incidental finding on x-rays and other imaging studies. It can however become symptomatic when the synchondrosis is disrupted (as likely happened in this case). When present an os supranaviculare may also increase the risk of a player developing a navicular stress fracture. An avulsion fracture from the dorsal navicular can also occur after an acute traumatic incident. These fractures are generally more irregular and are not corticated.

In most cases an os supranaviculare does not require any specific treatment. If the synchondrosis becomes disrupted a player’s symptoms will often resolve with a short period of rest. Where the pain is more refractory, excising the os is generally an effective treatment.

Important notice
FIFA does not bear any responsibility for the accuracy and completeness of any information provided in the “Radiology Review” features and cannot be held liable with regard to the information provided or any acts or omissions occurring on the basis of this information.

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Neil S. Jose
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Neil S. Jose

Great help… thanks!!!!

Sachin kumar
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Sachin kumar

It was the good case discussion and we can added some foot wear correction and focusing on strengthening and stretching exercises of foot and leg muscles .

HD
Member
HD

Good thanx

Bangoura
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Bangoura

L OS SUPRANAVICULAIRE DU LATIN NAVICULAR QUI SIGNIFIT PETIT BATEAU EST UN OS DU PIED AUTREFOIS APPELE SCAPHOIDE. C EST GENERALEMENT DANS LA PRATIQUE DU SPORT QU INTERVIENT LES LESIONS. ELLES SONT GENERALEMENT BENIGNES ET LA DOULEUR INTERVIENT DE FACON INCIDIEUSES.
D UNE SIMPLE ENTORSE EN PASSANT PAR UNE FRACTURE DE STRESS OU UNE OSTEOPOROSE APRES 60 ANS.
LES EXAMENS D IMAGERIE
RADIOGRAPHIE
L IRM
SCANER
LE TRAITEMENT EST D ABORD MEDICAL
CHIRURGICAL EN FONCTION DU TYPE DE FRACTURE
ORTHOPEDIQUE EN FONCTION DU TYPE DE FRACTURE LA POSE D UN PLATRE PEUT ETRE NECESSAIRE
REPRISE 06 SEMAINES APRES

Alaa alagooz
Member
Alaa alagooz

ممكن اعرف ازى اغير اللغة الي عربية

Dr.naglaa Muhammad Ibrahim
Member
Dr.naglaa Muhammad Ibrahim

قم بتفعيل جوجل ترانسليت على الهاتف أو على جوجل كروم
ويمكنك التواصل معي للمساعدة

Ibrahim
Member
Ibrahim

من فضلك هل في امكانيه ان يكون المحتوي مترجم الي العربية

Tayma Mohammad al-naimat
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Tayma Mohammad al-naimat

😍😍

Bangoura
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Bangoura

LireNAVICULAR EN LIEU DE NAVICULAIRE
LIREOS NAVICULAIRE

Rodrigo Peixoto dos Santos
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Rodrigo Peixoto dos Santos

Interesting case and that usually starts pain after trauma! Cool to remember

Ayham alshoufeen
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Ayham alshoufeen

Thanks

Jamaleddine almouhandiz
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Jamaleddine almouhandiz

حالة مثيرة للألم مناقشة جيدة

Jahid khan
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Jahid khan

Intresting case and pain can be start after truama !

Jahid khan
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Jahid khan

Intersting case and pain can be start after trauma ! Strengthening excercise will be start

Dr.k.hareesh kasimabanthi
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Good education knowledge thanks

Dr.k.hareesh kasimabanthi
Member

Physiotherapy sports medicine

Dr.k.hareesh kasimabanthi
Member

Physiotherapy

KARTHICK K
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KARTHICK K

Interesting case and that usually starts pain after trauma! Cool to remember

Jamaleddine almouhandiz
Member
Jamaleddine almouhandiz

الم حاد حاد بعد الصدمة