Symptomatic Os Infranaviculare

The author observed a new accessory bone of the foot in the distal portion of navicular, which articulated with the medial cuneiform and the intermediate cuneiform, and named it os infranaviculare. A degenerative change was observed between the accessory bone and the navicular; this caused midfoot pain to the patient during weight-bearing. Thus, the patient was treated by excision of the accessory bone. The symptom was relieved at one-year postoperative.

MR Imaging Findings of Painful Type II Accessory Navicular Bone: Correlation with Surgical and Pathologic Studies

OBJECTIVE: To evaluate the MR imaging findings of painful type II accessory navicular bone and to correlate these with the surgical and pathologic findings. MATERIALS AND METHODS: The MR images of 17 patients with medial foot pain and surgically proven type II accessory navicular abnormalities were reviewed. The changes of signal intensity in the accessory navicular, synchondrosis and adjacent soft tissue, the presence of synchondrosis widening, and posterior tibial tendon (PTT) pathology on the T1-weighted and fat-suppressed T2-weighted images were analyzed. The MR imaging findings were compared with the surgical and pathologic findings. RESULTS: The fat-suppressed T2-weighted images showed high signal intensity in the accessory navicular bones and synchondroses in all patients, and in the soft tissue in 11 (64.7%) of the 17 patients, as well as synchondrosis widening in 3 (17.6%) of the 17 patients. The MR images showed tendon pathology in 12 (75%) of the 16 patients with PTT dysfunction at surgery. The pathologic findings of 16 surgical specimens included areas of osteonecrosis with granulomatous inflammation, fibrosis and destruction of the cartilage cap. CONCLUSION: The MR imaging findings of painful type II accessory navicular bone are a persistent edema pattern in the accessory navicular bone and within the synchondrosis, indicating osteonecrosis, inflammation and destruction of the cartilage cap. Posterior tibial tendon dysfunction was clinically evident in most patients.

Evidence for a new ad sysdrome: report of a large iranin sibship with severe multiple synostosis

An investigation was carried out on a young unrelated couple, both 29 years old, with two boys and three girls, 3 months to 8 years old. One boy and the mother were healthy, the other four children and the father were affected. The family, originally from the district of Nour, in northern Iran, near the Caspian Sea, was first counseled at the Genetic Clinic in Tehran in 1984. Several trips were made to the location in a period of five years, to examine this large family. The major anomalies in this family were brachyphalangia, elbow joint aplasia [humero - radial synostosis, 110 to 140°C], carpal/tarsal synostosis and talus/calcaneus fusion. All affected individuals present a fixation of the feet in supination position and because of partial synostosis [physis] of calcaneus and talus, walked on lateral side with the external cant of the foot. All deformities were studied by clinical examinations and radiological confirmations, on each affected individual