Search Results (3)

This report describes a unique constellation of accessory ossicles, highlighting their anatomical, clinical, and radiological significance. A 43-year-old female undergoing imaging for suspected fracture was evaluated using multi-detector computed tomography (MDCT) with 1.25 mm slice thickness. Multiplanar reconstructions (axial, coronal, sagittal) and three-dimensional volume-rendered images were analyzed. CT imaging revealed the coexistence of an os subfibulare and a tripartite os naviculare. Multiplanar and three-dimensional reconstructions confirmed the presence and configuration of variants. The combination of supernumerary bones and a multipartite ossicle represents an exceedingly uncommon anatomical presentation. This case illustrates an exceptional coexistence of multiple accessory ossicles, including an exceedingly rare tripartite os naviculare. Thorough radiological evaluation using MDCT and multiplanar reconstructions is essential for accurate identification and differentiation from fractures or other pathology. Full article

Background and Objectives: The incidence of accessory bones in the region of foot and ankle is quite variable between studies and are often confused with avulsion fractures in trauma patients with musculoskeletal injuries. The aim of this study was to assess the incidence of accessory ossicles of the foot and ankle according to gender, side and coexistence, and to determine how frequently accessory ossicles were misdiagnosed as avulsion fractures. Materials and Methods: Oblique and/or lateral foot radiographs of 1000 adult patients referred from emergency departments to foot and ankle clinic were retrospectively reviewed for the presence of accessory ossicles. The Kappa statistic was used in order to assess the validity of radiographic interpretation for the presence of these bones. Results: Accessory ossicles were detected in 40.2% of the radiographs. The incidence rates for the accessory ossicles in order of frequency were: Os trigonum (15.4%), accessory navicular (13.7%), os peroneum (11.5%), os vesalianum (1.1%), os supranaviculare (0.7%), os subfibulare (0.6%), os talotibiale (0.4%), os calcaneus secundarius (0.3%), os supratalare (0.3%), os infranaviculare (0.3%), os intermetatarseum (0.2%), and os subtibiale (0.1%). Coexistence of two or three ossicles in the same foot was observed in 4.4% of the cases, mostly coexistence with os peroneum (2.9%), followed by accessory navicular (1.6%). 2.7% of accessory ossicles were initially misdiagnosed as avulsion fractures at emergency departments. Interrater agreement over identification of different accessory ossicles was found to be reasonably reliable, with a Kappa greater than 0.80 for all assessed bones. Conclusions: In clinical practice, a thorough knowledge of normal anatomical variants is essential to facilitate appropriate diagnosis and treatment and can help to prevent diagnostic errors. Full article

During dissection of a cadaver at the Ohio College of Podiatric Medicine, the authors encountered the os subfibulare. The os subfibulare was encased within the peroneus longus and peroneus brevis tendons and initially appeared as though it may have articulated with the left lateral malleolus distally and posteriorly. The ossicle was not associated with any capsular or ligamentous structures. These findings suggest that the os subfibulare is a true sesamoid bone. A review of the literature is presented and the clinical significance of these findings is discussed. Full article