Accessory navicular syndrome as a cause of foot pain during stroke rehabilitation

• Published in: Age and ageing Vol. 48; no. 1; pp. 159 - 161
• Main Authors: Mulkerrin, Patrick, McLoughlin, Ray, O’Keeffe, Shaun T
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.01.2019; Oxford Publishing Limited (England)
• Subjects: Aged; Bones; Feet; Foot; Foot diseases; Foot Diseases - complications; Foot Diseases - diagnosis; Foot Diseases - diagnostic imaging; Humans; Male; Pain; Pain - etiology; Rehabilitation; Shoes & boots; Sports; Stroke; Stroke Rehabilitation - adverse effects; Syndrome; Tarsal Bones - abnormalities; Tarsal Bones - diagnostic imaging; stroke rehabilitation; older people; foot pain; accessory navicular syndrome
• ISSN: 0002-0729; 1468-2834
• DOI: 10.1093/ageing/afy165

Abstract Although usually asymptomatic, an accessory navicular bone can lead to medial foot pain, especially in younger people engaged in high impact sports. In many such cases, the tendon of posterior tibialis (which inverts and plantarflexes the foot) inserts onto the accessory bone resulting in greater strain on the tendon. In the present case, pain due to an accessory navicular bone first developed during stroke rehabilitation in a 69-year-old man. The relative overactivity of posterior tibialis in strokes involving the leg and overuse due to active rehabilitation were likely contributors. An accessory navicular syndrome should be considered as a cause of medial foot pain in patients following a stroke. As in our case, conservative management with rest, ice and elevation is usually successful.