Painful Accessory Bones of the Foot

ABSTRACT

Sesamoid bones and secondary centers of ossification account for the accessory bones of the foot, and there is a wide range of frequency with which these different ossicles appear. They are usually incidental asymptomatic findings on imaging studies, and their clinical importance lies in not mistaking them for fractures. Occasionally these ossicles can become painful due to fracture, degenerative changes, avascular necrosis, and irritation or impingement of adjacent soft tissue.

KEYWORDS

Sesamoid bones - accessory ossicles - symptomatic normal variants

REFERENCES

• 1 Sarin V K, Erickson G M, Giori N J, Bergman A G, Carter D R. Coincident development of sesamoid bones and clues to their evolution.  Anat Rec . 1999;  257 174-180
• 2 Logan P M, Connell D G, Janzen D L. Painful os cuboideum secundarium: cross sectional imaging findings.  J Am Podiatr Med Assoc . 1996;  86 123-125
• 3 Kruse R W, Chen J. Accessory bones of the foot: clinical significance.  Mil Med . 1995;  160 464-467
• 4 Tsuruta T, Shiokawa Y, Kato A. Radiological study of the accessory skeletal elements in the foot and ankle.  Nippon Seikeigeka Gakkai Zasshi . 1981;  55 357-370
• 5 Sobel M, Pavlov H, Geppert M J, Thompson F M, DiCarlo E F. Painful os peroneum syndrome: a spectrum of conditions responsible for plantar lateral foot pain.  Foot Ankle Int . 1994;  15 112-124
• 6 Burton S K, Altman M I. Degenerative arthritis of the os peroneum: a case report.  J Am Podiatr Med Assoc . 1986;  76 343-345
• 7 Crain M R, El-Khoury G Y. Stress fracture of the os peroneum.  AJR Am J Roentgenol . 1989;  152 430
• 8 Bessette B J, Hodge J C. Diagnosis of the acute os peroneum fracture.  Singapore Med J . 1998;  39 326-327
• 9 Bianchi S, Abdelwahab I F, Tegaldo G. Fracture and posterior dislocation of the os peroneum associated with rupture of the peroneus longus tendon.  Can Assoc Radiol J . 1991;  42 340-344
• 10 Pessina R. Os peroneum fracture: a case report.  Clin Orthop . 1988;  227 261-264
• 11 Peterson J J, Bancroft L W. Os peroneal fracture with associated peroneus longus tendinopathy.  AJR Am J Roentgenol . 2001;  177 257-258
• 12 Lawson J P, Ogden J A, Sella E, Barwick K W. The painful accessory navicular.  Skeletal Radiol . 1984;  12 250-262
• 13 Sella E J, Lawson J P, Ogden J A. The accessory navicular synchondrosis.  Clin Orthop . 1986;  209 280-285
• 14 Miller T T, Staron R B, Feldman F, Parisien M, Glucksman W J, Gandolfo L H. The symptomatic accessory tarsal navicular bone: assessment with MR imaging.  Radiology . 1995;  195 849-853
• 15 Romanowski C AJ, Barrington N A. The accessory navicular-an important cause of medial foot pain.  Clin Radiol . 1992;  46 261-264
• 16 Mygind H B. The accessory tarsal scaphoid: clinical features and treatment.  Acta Orthop Scand . 1953;  23 142-151
• 17 Chiu N T, Jou I M, Lee B F, Yao W J, Tu D G, Wu P S. Symptomatic and asymptomatic accessory navicular bones: findings of Tc-99m MDP bone scintigraphy.  Clin Radiol . 2000;  55 353-355
• 18 Jones D M, Saltzman C L, El-Khoury G. The diagnosis of the os trigonum syndrome with a fluoroscopically controlled injection of local anesthetic.  Iowa Orthopaed J . 1999;  19 122-126
• 19 Karasick D, Schweitzer M E. The os trigonum syndrome: imaging features.  AJR Am J Roentgenol . 1996;  166 125-129
• 20 Blake R L, Lallas P J, Ferguson H. The os trigonum syndrome: a literature review.  J Am Podiatr Med Assoc . 1992;  82 154-161
• 21 Wenig J A. Os trignonum sydrome.  J Am Podiatr Med Assoc . 1990;  80 278-282
• 22 Hamilton W G. Foot and ankle injuries in dancers.  Clin Sports Med . 1988;  7 143-173
• 23 Bureau N J, Cardinal E, Hobden R, Aubin B. Posterior ankle impingement syndrome: MR imaging findings in seven patients.  Radiology . 2000;  215 497-503
• 24 Wredmark T, Carlstedt C A, Bauer H, Saartok T. Os trigonum syndrome: a clinical entity in ballet dancers.  Foot Ankle . 1991;  11 404-406
• 25 Sopov V, Liberson A, Groshar D. Bone scintigraphic findings of os trigonum: a prospective study of 100 soldiers on active duty.  Foot Ankle Int . 2000;  21 822-824
• 26 Case D T, Ossenberg N S, Burnett S E. Os intermetatarseum: a heritable accessory bone of the human foot.  Am J Phys Anthropol . 1998;  107 199-209
• 27 Reichmister J P. The painful os intermetatarseum: a brief review and case reports.  Clin Orthop . 1980;  153 201-203
• 28 Noguchi M, Iwata Y, Miura K, Kusaka Y. A painful os intermetatarseum in a soccer player: a case report.  Foot Ankle Int . 2000;  21 1040-1042
• 29 Potter H G, Pavlov H, Abrahams T G. The hallux sesamoids revisited.  Skeletal Radiol . 1992;  21 437-444
• 30 Feldman F, Pochaczevsky R, Hecht H. The case of the wandering sesamoid and other sesamoid afflictions.  Radiology . 1970;  96 275-283
• 31 Frankel J P, Harrington J. Symptomatic bipartite sesamoids.  J Foot Surg . 1990;  29 318-323
• 32 Richardson E G. Injuries to the hallucal sesamoids in the athlete.  Foot Ankle . 1987;  7 229-244
• 33 Rodeo S A, Warren R F, O'Brien S J, Pavlov H, Barnes R, Hanks G. Diastasis of bipartite sesamoids of the first metatarsophalangeal joint.  Foot Ankle . 1993;  14 425-434
• 34 Fleischli J, Cheleuitte E. Avascular necrosis of the hallucial sesamoids.  J Foot Ankle Surg . 1995;  34 358-365
• 35 McBryde A M, Anderson R B. Sesamoid foot problems in the athlete.  Clin Sports Med . 1988;  7 51-60
• 36 Velkes S, Pritsch M, Horoszowski H. Osteochondritis of the first metatarsal sesamoids.  Arch Orthop Trauma Surg . 1988;  107 369-371
• 37 Grace D L. Sesamoid problems.  Foot Ankle Clin . 2000;  5 609-627
• 38 Oloff L M, Schulhofer S D. Sesamoid complex disorders.  Clin Podiatr Med Surg . 1996;  13 497-513