Symptomatic Ossicles Flashcards
What are the 2 most prominent areas of the medial aspect of teh foot?
prominence of navicular head and talar prominence
what happens to talar prominence with STJ pronation?
prominence is exaggerated with STJ pronation
what happens to talar prominence with STJ supination?
prominence is reduced with STJ supination
what is the most common accessory ossicle?
the accessory navicular
*has 3 typical presentations
at what age can navicular prominence be seen radiographically?
age 9-11
what is the type 1 navicular prominence?
- small ossicle proximal to navicular tuberosity
- is classified as a true sesamoid bc it is within the tibialis posterior tendon
what is the type 2 navicular prominence?
-true accessory scaphoid appears radiographically as an extension of the navicular (its connection to navicular is represented by a radiolucent zone
what is type 3 navicular prominence?
represents a true carnuate navicular or enlarged navicular tuberosity
(may be type 2 with an osseous bridge)
what is the conservative treatment for talar prominence?
-functional orthoses
-AFO
-shoe modification
-steroid injection
-steroids
NSAIDs
what are some surgical options for treating talar prominence?
arthrodesis (fusion) of STJ, mid-tarsal joint (CC; Talonavicular) or all 3
what is the conservative treatment for navicular prominences?
(very similar to talar prominences)
- immobilization, NSAIDs, NWB
- shoe modification
- AFO
how would you do surgery for a type 1 navicular prominence?
-remove the ossicle from the tendon by using a tendon splitting approach or reflection of the tibialis posterior from the tn joint capsule & then removing the ossicle
how would you do surgery for a type 2 navicular prominence?
- visualize the mass using imaging
- excision of the fragment
- may result in wekaening of tendon or capsule
what position should i be in for surgery to type 3 neurological preference?
STJ supinated
what is dorsal bossing?
(of the 1st tarso-metatarsal joint) is a common acquired disorder of the foot that leads to arthritic changes
bony prominece at teh 1st met-cuneiform joint can be classified by types. what is type 1? etiology?
DORSAL exostosis formation located at 1st met-cuneiform joint
*etiology: FF valgus plantarflexed 1st ray
bony prominece at teh 1st met-cuneiform joint can be classified by types. what is type 2? etiology?
exostosis located circumeferentially (dorsal, medial, and plantar)
- has an arthritic component also
- etiology: trauma, arthritis
bony prominece at teh 1st met-cuneiform joint can be classified by types. what is type 3?
DORSAL exostosis of 1st met-cuneiform joint + angular malalignment
(1st met dorsiflexes, plantarflexes, adducts)
bony prominece at teh 1st met-cuneiform joint can be classified by types. what is type 4?
dorsal exostosis + Lis Franc’s joint
bony prominece at teh 1st met-cuneiform joint can be classified by types. what is type 5?
pseudo exostosis secondary to position (ex. pes cavus) that causes
what is os vesalinium?
accessory bone located at the base of the 5th met
where is os tibiale externum located?
on navicular tuberosity
where is os peroneus found?
accessory bone located inferior to the peroneal groove of the cuboid
(encompassed within peroneus longus tendon)
where is os trigonum found?
lateral process of the posterior aspect of teh talus
when does os trigonum fues with talus usually?
age 18
irritation of os trigonum is caused by which tendon?
flexor hallucis longus
