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.


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.


CONCLUSIONS
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.
Choi
Yun Sun
YS
Department of Diagnostic Radiology, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea. cys0128@eulji.or.kr
Lee
Kyung Tai
KT
Kang
Heung Sik
HS
Kim
Eun Kyung
EK
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007723:Korea; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D010020:Osteonecrosis / Q000175:diagnosis / Q000601:surgery; D010146:Pain / Q000473:pathology; D037081:Posterior Tibial Tendon Dysfunction / Q000175:diagnosis / Q000601:surgery; D011859:Radiography; D013639:Tarsal Bones / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D052256:Tendinopathy / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome