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05.10.2012 Рентгенография стоп. Os tibiale externum с обеих сторон

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Похоже на варусную деформацию

Похоже на варусную деформацию 1-х предплюснево-плюсневых суставов.

 
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несросшийся апофиз

несросшийся апофиз ладьевидной кости .возможно тут есть и продольное плоскостопие

 
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Os tibiale externum с обеих

Os tibiale externum с обеих сторон.

 
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+1  

+1

 

 
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+1.Кстати, такие изменения

+1.Кстати, такие изменения могут давать клинику.

 
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+1

+1

 
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  Os tibiale externum Dr

 

An os tibiale externum (or accessory navicular / os naviculare) is a large ossicle adjacent to the medial side of the navicular bone. The tibialis posterior tendon often inserts with a broad attachment onto the ossicle. Most cases are asymptomatic but in a small proportion it may cause a painful tendinosis due traction between the ossicle and the navicular. Such changes are best seen on MRI.

  • an accessory navicular bone is located posterior to the posteromedial tuberosity of the tarsal navicular bone.
  • an accessory navicular bone is present in 4 - 21% of the population.
  • first appears in adolescence.
  • more common in female patients.
  • reported prevalence of bilaterality varies from 50 - 90%

Classification

Th Geist classification divides these into 3 types.

  • type 1 accessory navicular bone
    • also known as os tibiale externum
    • 2 - 3 mm sesamoid bone embedded within the distal portion of the posterior tibial tendon.
    • It does not have a cartilaginous connection to the naviculam tuberosity and may be separated from it by up to 5 mm.
    • accounts for 30% of accessory navicular bones
    • usually asymptomatic
  • type 2 accessory navicular bone
    • triangular or heart-shaped
    • measures up to 12 mm
    • accounts for 50 - 60% of all ossicles.
    • connected to the naviculam tuberosity by a 1-2-mm thick layer of either fibrocartilage on hyaline cartilage.
    • eventual osseous fusion to the navicular tuberosity may take place
  • type 3 accessory navicular bone
    • an especially prominent navicular tuberosity called a cornuate navicular
    • thought to represent a fused type 2 and is occasionally symptomatic as a result of painful bunion formation over the bony protuberance.

 

 
 

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