Accessory Navicular

Summary

  • Presents as a painful lump on the medial side of the foot, usually due to irritation from footwear
    Usually asymptomatic.

Diagnostic tips

  1. Often tender on palpation.
  2. Can be associated with a low arch or flat foot.
  3. Stress from the posterior tibial tendon may contribute to symptoms.

Tests and Imaging

  1. Plain xray.
  2. Ultrasound or MRI may determine posterior tibial tendon involvement.

Immediate Treatment

  1. Appropriate footwear with internal padding.
  2. Additional foam or gel padding.
  3. Activity modification.
  4. Weight loss.

Possible Referral

  1. Podiatry for footwear advice and possible modification.
  2. Podiatry for orthotic inserts to relieve stress from the posterior tibial tendon.
  3. Surgeon only after failiure of non-operative treatment.9-12 months recovery after 6-12 weeks immobilisation.

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