The symptomatic accessory tarsal navicular bone: assessment with MR imaging.

Abstract

The BMEP in a symptomatic accessory navicular bone is indicative of chronic stress and/or osteonecrosis. This information can furnish an objective basis for surgical or conservative management.

Magnetic resonance imaging in adolescent symptomatic navicular tuberosity

“…The results of this study indicate that symptomatic navicular in adolescence is described by an edema-like bone marrow pattern on MR image regardless of whether an accessory navicular is present or not, and that alleviation of the symptom is proportional to the diminish of the edema-like bone marrow pattern. The edema-like bone marrow pattern has been typically shown for symptomatic type II accessory navicular bones, in which the both sides of the synchondrosis present this pattern (9)(10)(11) . In the present study, there were three patients who did not have accessory navicular bones (cases 4, 5 and 8) but still showed an edema-like bone marrow pattern on the navicular tuberosity.…”

“…Second, we did not have surgical or histologic correction of samples. The edema-like bone marrow pattern have been reported to reflect several different pathologic conditions except for true edema, such as bone marrow necrosis and fibrosis (21), fibrovascular tissue ingrowth and increased blood flow to the area (22), and reactive new bone formation (9). The background of conditions such as age of the patient, the cause of trauma, and anatomic location should be taken into account.…”

“…Pulse sequences comprised spin-echo (SE) T1-weighted (repetition time/echo time (TR/TE), 400-500/16-20, 4.0 mm slice thickness ; 22 cm field of view, 256!256 matrix) and SE T2-weighted fat saturated (TR/effective TE, 4,200-4,500/30-38, 4.0 mm slice thickness ; 16-22 cm field of view, 256!256 matrix) images obtained in the horizontal and axial planes. MR abnormality was "edema-like bone marrow pattern", which was depicted as an area of low signal intensity on T1-weighted images with high signal intensity on T2-weighted fat-saturated images (9,16,17). Neither conventional T2-weighted image nor contrast enhancement using an infusion of gadolinium was applied in this study.…”

“…resonance (MR) images of symptomatic type II (synchondrosis type) accessory navicular bone showed an "edema-like bone marrow pattern" (9)(10)(11). Edema-like MR abnormality was also reported in the posterior tibial tendon in adults with flatfoot (12,13).…”

Imaging Findings of CT and MRI of Os Supratalare: A Case Report

“…Similar MRI findings had been reported in os sustentaculi and accessory navicular bone. According to their reports, these findings can be interpreted as degenerative/reparative changes due to chronic stresses at the synchondrosis and the source of pain (6,8).…”