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Accessory bones of the foot and ankle are far more
common then reported. All of which can become symptomatic if injured. Other then the sesamoids associated with 1st MPJ,
no accessory bone is immune to injury or becoming annoyed. Surgical excision can become necessary.
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Research:
To present a review of accessory
bones of the foot and ankle over a three year-period. Over 70,000 foot and ankle xrays were reviewed. All accessory bones
were identified by type and location.
Results:
A total of 1000 patients were found to have accessory bones.
The most common accessory bone of the foot and ankle was os trigonum (443). The following names bones were identified: os
tibiale externum (345), os perineum/vesalium (308), os fibulare (14), and os supranaviculare (6). Accessory bones were also
noted at the following locations: 1st IPJ (115), lesser metatarsal head (65), and medial malleolous (32). Accessory bones
of the lesser metatarsal heads were found at multiple sites with 67 patients.
Forty-six patients had at least three
additional accessory bones; seventeen were found to have at least five; and one teenage girl had eight accessory bones on
one foot.
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These are all accessory bones sitting within flexor tendons.
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Another case, with two accessory bones: os trigonum and os naviculare
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This is not an accessory bone
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There are no accessory bone here, just loose bodies.
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Lateral view showing loose bodies not accessory bones but actually synovial osteochondromatosis
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