Incidence and anatomical variability of accessory and sesamoid bones of the foot

Arslan, Serdar; Bakdik, Suleyman; Öncü, Fatih; Karahan, Ali Yavuz; Durmaz, Mehmet Sedat; Özen, Kemal Emre; Cicekbasi, Aynur Emine

doi:10.5455/annalsmedres.2018.05.078

Cited by 9 publications

(5 citation statements)

References 13 publications

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“…In our study type I ANB had the smallest average size of 0.54 cm (0.24 cm); type IIA was 0.87 cm (0.32 cm); type IIB was 1.20 cm (0.25 cm); and type III had the largest average size of 1.95 cm (0.36 cm). Another study by Arslan et al 13 noted the size range from 814 foot x-rays were as follows: type I (0.09-0.97 cm), type II (0.26–1.3 cm), and type III (0.5–2.28 cm); these measurements were similar to those in our study.…”

Section: Discussionsupporting

confidence: 90%

“…In multipartite bones such as bipartite and tripartite bones, each bone was measured separately. 13 Classification of multipartite bones were based on the largest bone. The following information was recorded for each ANB: site (left, right, or bilateral), size (highest axial measurements), classification (Type I, IIA, IIB, III), subtypes (a, b, c), and whether they were symptomatic.…”

Section: Methodsmentioning

confidence: 99%

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Prevalence and classification of accessory navicular bone: a medical record review

et al. 2022

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BACKGROUND: The accessory navicular bone (ANB) is one of the most common accessory bones in the foot. Certain pathologies, such as posterior tibial tendon insufficiency are associated with ANB, and should be differentiated from midfoot and hindfoot fractures such as navicular tuberosity avulsion fractures. There are few studies addressing the prevalence and types of ANB in Saudi Arabia. OBJECTIVES: Determine the prevalence and morphological variations of ANB and its relation with age and sex in patients visiting foot and ankle clinics. DESIGN: Medical record review SETTING: Orthopedic foot and ankle clinic at a university hospital. PATIENTS AND METHODS: The presence of ANB was retrospectively analyzed in radiographs from patients who presented to the orthopedic foot and ankle at our university hospital from February 2010 to December 2020. The patients were stratified according to sex, age, and diagnosis. For each ANB, recorded information included site, size, classification, subtypes, and symptomatology. Purposive sampling was used to select the patients for the study (non-probability sampling). MAIN OUTCOME MEASURES: Prevalence of ANB in patients attending a foot and ankle clinic. SAMPLE SIZE: 117 patients and 194 feet. RESULTS: ANB was analyzed in 1006 radiographs from 503 patients. ANB was detected in 117 (23.3%) patients and 194 (19.3%) feet Prevalence was significantly higher in females (67.5%) than in males (32.5%) (Z=5.359, P <.001). The ages ranged from 19 to 86 years, with a mean age of 48.26 (14.5) years. The most common site was bilateral (77 patients, 65.8 %). Type I was the most common type, with a prevalence of 42.1%. There were no significant differences in types in relation to sex, but all types and subtypes differed significantly from each other. CONCLUSION: ANB was common among patients presenting to the foot and ankle clinic, with an overall prevalence of 23.3%. It should be considered among the differential diagnosis in chronic foot pain, and should be differentiated from midfoot and hindfoot fractures. Further studies with a larger, randomized sample are needed, for more accuracy and to confirm the reported results. LIMITATIONS: Retrospective chart review, non-probability sampling, and use of plain radiographs. CONFLICT OF INTEREST: None.

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Prevalence and classification of accessory navicular bone: a medical record review

et al. 2022

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“…Os naviculare accessoria, also called os tibiale externum, is the third most common accessory ossicle in our study. Its reported prevalence varies between 4 and 34% (23,24). Although it was found bilaterally in 3 patients in our study, it may be bilateral up to 50% according to some studies (5).…”

Section: Discussioncontrasting

confidence: 55%

Accessory and Sesamoid Bones in the Body: A study on their Size and Presence

DEĞERMENCİ,

AYGÜN,

YILMAZ

et al. 2024

Medical Records

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Aim: Accessory and sesamoid bones are hidden anatomical structures that fulfil a wide variety of functions in the human body. Therefore, studying the nature, formation and dimensions of these structures is of great importance for the medical literature. In our study, we aimed to measure the presence and area (size) of these ossicles. Material and Method: Our study was performed retrospectively on the images of individuals who applied to Ordu University and whose radiological images were obtained. The presence of accessory and sesamoid ossicles (present/absent) and their sizes (measured using the PACS system) were evaluated on radiographs and CT images. The results of the ossicles were divided into gender, age, and bilateral groups. Statistical analyzes were performed with the SPSS program. Results: The most common and largest accessory ossicles in the foot were os peroneum (18.2%), os naviculare accessoria (17.4%), os trigonum (12.1%) and os intermetatarsarum (7.8%). Sesamoid ossicles at the level of the first metatarsophalangeal joint of the foot and the first metacarpopgalangeal joint of the hand were found to be 100% common. The second most common sesamoid bone in the hand and foot was at the fifth mtp (22.22%) and mcp (68.53%) joints. In the hand, the most common accessory ossicles were os triangulare (6.08%), os radiale externum (2.60%) and os centrale (1.73%). Accessory ossicles (fabella: 19%, cyamella: 17.5%) were found in 25.5% of the knee. Conclusion: Accessory and sesamoid ossicles are most commonly found in the hand, foot, and knee. The presence and size of these ossicles can be both beneficial and harmful. Sesamoids provide mechanical benefit, whereas accessory ossicles can be mistaken for fractures and may lead to unnecessary medical conditions. Knowing the dimensions of these ossicles allows them to be clinically differentiated from avulsion fractures.

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“…However, a high incidence of accessory ossicles was also reported in a healthy asymptomatic population. In a recent Korean population study, accessory ossicles were found in 49.2% of the healthy, asymptomatic Korean adults [10]. Additionally, in a CT-based study, accessory bones were detected in 47.5% of the scans.…”

Section: Discussionmentioning

confidence: 90%

Accessory Ossicles in the Region of the Foot and Ankle: An Epidemiologic Survey in a Jordanian Population

et al. 2021

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Background and Objectives: The incidence of accessory bones in the region of foot and ankle is quite variable between studies and are often confused with avulsion fractures in trauma patients with musculoskeletal injuries. The aim of this study was to assess the incidence of accessory ossicles of the foot and ankle according to gender, side and coexistence, and to determine how frequently accessory ossicles were misdiagnosed as avulsion fractures. Materials and Methods: Oblique and/or lateral foot radiographs of 1000 adult patients referred from emergency departments to foot and ankle clinic were retrospectively reviewed for the presence of accessory ossicles. The Kappa statistic was used in order to assess the validity of radiographic interpretation for the presence of these bones. Results: Accessory ossicles were detected in 40.2% of the radiographs. The incidence rates for the accessory ossicles in order of frequency were: Os trigonum (15.4%), accessory navicular (13.7%), os peroneum (11.5%), os vesalianum (1.1%), os supranaviculare (0.7%), os subfibulare (0.6%), os talotibiale (0.4%), os calcaneus secundarius (0.3%), os supratalare (0.3%), os infranaviculare (0.3%), os intermetatarseum (0.2%), and os subtibiale (0.1%). Coexistence of two or three ossicles in the same foot was observed in 4.4% of the cases, mostly coexistence with os peroneum (2.9%), followed by accessory navicular (1.6%). 2.7% of accessory ossicles were initially misdiagnosed as avulsion fractures at emergency departments. Interrater agreement over identification of different accessory ossicles was found to be reasonably reliable, with a Kappa greater than 0.80 for all assessed bones. Conclusions: In clinical practice, a thorough knowledge of normal anatomical variants is essential to facilitate appropriate diagnosis and treatment and can help to prevent diagnostic errors.

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Incidence and anatomical variability of accessory and sesamoid bones of the foot

Cited by 9 publications

References 13 publications

Prevalence and classification of accessory navicular bone: a medical record review

Prevalence and classification of accessory navicular bone: a medical record review

Accessory and Sesamoid Bones in the Body: A study on their Size and Presence

Accessory Ossicles in the Region of the Foot and Ankle: An Epidemiologic Survey in a Jordanian Population

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