Try it
Orthopaedics · Foot: accessory navicular
Sample itemA 12-year-old girl has pain and a bony prominence on the medial border of the midfoot that is aggravated by tight shoes. Radiographs show a separate ossicle attached to the navicular tuberosity, and the tibialis posterior tendon inserts into it. What is the likely diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Accessory navicular
An accessory navicular is an extra ossicle at the medial navicular tuberosity, present in a minority of people. It may become painful from shoe pressure or traction of tibialis posterior and is often associated with flatfoot. Management is with padding, orthoses and rest, and excision for persistent symptoms.
Option by option
A. Sever disease
Sever disease is calcaneal apophysitis.
B. Accessory navicular (correct)
Correct. A medial navicular ossicle with tibialis posterior insertion is an accessory navicular.
C. Kohler disease
Kohler disease is avascular necrosis of the whole navicular in young boys.
D. Freiberg infraction
Freiberg infraction is avascular necrosis of the second metatarsal head.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
More Orthopaedics questions
- Upper limb fracturesWhich complication is characteristic of a fracture through the waist of the scaphoid?
- Fractures in childrenA child with a displaced supracondylar fracture of the humerus develops a painful, pale…
- Bone tumoursA teenager has knee pain and a radiograph around the distal femur showing a sunburst per…
- HipA positive Trendelenburg sign is due to weakness of the gluteus medius and minimus. Whic…