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MR imaging findings of painful type II accessory navicular bone: correlation with surgical and pathologic studies.

Choi YS, Lee KT, Kang HS, Kim EK - Korean J Radiol (2004 Oct-Dec)

Bottom Line: The MR imaging findings were compared with the surgical and pathologic findings.The pathologic findings of 16 surgical specimens included areas of osteonecrosis with granulomatous inflammation, fibrosis and destruction of the cartilage cap.Posterior tibial tendon dysfunction was clinically evident in most patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea. cys0128@eulji.or.kr

ABSTRACT

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.

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Surgically proven partial tear of the posterior tibial tendon with painful accessory navicular bone in a 51-year-old woman.
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Figure 3: Surgically proven partial tear of the posterior tibial tendon with painful accessory navicular bone in a 51-year-old woman.

Mentions: The fat-suppressed T2-weighted FSE images showed high signal intensity accessory navicular bones and synchondroses resembling bone marrow edema patterns in all patients (Figs. 1-3). The high signal intensity was most intense adjacent to the synchondrosis and was also observed in the nontendinous soft tissue adjacent to the accessory navicular bones on the fat-suppressed T2-weighted FSE images in 11 (64.7%) of the 17 patients. The synchondrosis had widened in three (17.6%) of the 17 patients, and these three patients showed mobile accessory navicular bones at surgery.


MR imaging findings of painful type II accessory navicular bone: correlation with surgical and pathologic studies.

Choi YS, Lee KT, Kang HS, Kim EK - Korean J Radiol (2004 Oct-Dec)

Surgically proven partial tear of the posterior tibial tendon with painful accessory navicular bone in a 51-year-old woman.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2698172&req=5

Figure 3: Surgically proven partial tear of the posterior tibial tendon with painful accessory navicular bone in a 51-year-old woman.
Mentions: The fat-suppressed T2-weighted FSE images showed high signal intensity accessory navicular bones and synchondroses resembling bone marrow edema patterns in all patients (Figs. 1-3). The high signal intensity was most intense adjacent to the synchondrosis and was also observed in the nontendinous soft tissue adjacent to the accessory navicular bones on the fat-suppressed T2-weighted FSE images in 11 (64.7%) of the 17 patients. The synchondrosis had widened in three (17.6%) of the 17 patients, and these three patients showed mobile accessory navicular bones at surgery.

Bottom Line: The MR imaging findings were compared with the surgical and pathologic findings.The pathologic findings of 16 surgical specimens included areas of osteonecrosis with granulomatous inflammation, fibrosis and destruction of the cartilage cap.Posterior tibial tendon dysfunction was clinically evident in most patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea. cys0128@eulji.or.kr

ABSTRACT

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.

Show MeSH
Related in: MedlinePlus