Mehmet Sedat DURMAZ, Ali Yavuz KARAHAN, Kemal Emre OZEN, Süleyman BAKDIK, Serdar ARSLAN, Aynur Emine CİCEKBASİ, Fatih ONCU

Incidence and anatomical variability of accessory and sesamoid bones of the foot

Aim: We aimed to assess the incidence, mean size, patterns, and types of accessory and sesamoid bones of the foot using computed tomography.Material and Methods: A total of 814 non-contrast-enhanced computed tomography images of the foot obtained from 717 patients between October 2015 and January 2018 were investigated retrospectively. Images acquired in the original axial plane were used to perform multiplanar reconstruction in the coronal or sagittal planes. Incidence, mean size, patterns, and types of accessory and sesamoid bones were evaluated in all images.Results: Accessory bones were detected in 387 (47.5%) non-contrast-enhanced computed tomography scans from 326 patients (45.4%). Sixty-seven patients (9.3%) showed accessory bones on both sides; 133 patients (18.5%), only on the right side; and 126 patients (17.5%), only on the left side. The most common accessory bones of the foot were the os naviculare accessorium (24.8%), os trigonum, (20.3%), os peroneum (14.6%), os intermetatarseum (10.6%), os supranaviculare (3.1%), os supratalare (1.9%), and osvesalianum (1.5%). The hallucal sesamoid bone was observed in all patients, while the interphalangeal sesamoid bone was observed in 34.6% of the patients.Conclusions: The computed tomography scans provided a detailed overview of the characteristics of accessory and sesamoid bones, and the incidence of these bones in our patients was higher than those reported in previous radiographic studies. Our findings can facilitate the diagnosis and management of disorders involving these bones.

PDF

___

Du H, Nie L, Wang HS, et al. Chondromalacia of sesamoids in first metatarsophalangeal joint. Chin J Traumatol 2004;7:127-8.
Le Minor JM. Congenital absence of the lateral metatarsophalangeal sesamoid bone of the human hallux: a case report. Surg Radiol Anat 1999;21:225-7.
Champagne IM, Cook DL, Kestner SC, et al. Os subfibulare. Investigation of an accessory bone. J Am Podiatr Med Assoc 1999;89:520-4.
Kose O. Os vesalianum pedis misdiagnosed as fifth metatarsal avulsion fracture. Emerg Med Australas 2009;21:426.
Boya H, Ozcan O, Tandogan R, et al. Os vesalianum pedis. J Am Podiatr Med Assoc 2005;95:583-5.
Cilli F, Akcaoglu M. [The incidence of accessory bones of the foot and their clinical significance]. Acta Orthop Traumatol Turc 2005;39:243-6.
Sobel M, Pavlov H, Geppert MJ, et al. Painful os peroneum syndrome: a spectrum of conditions responsible for plantar lateral foot pain. Foot Ankle Int 1994;15:112-24.
Miller TT. Painful accessory bones of the foot. Semin Musculoskelet Radiol 2002;6:153-61.
Karasick D, Schweitzer ME. The os trigonum syndrome: imaging features. AJR Am J Roentgenol 1996;166:125-9.
Huang J, Zhang Y, Ma X, et al. Accessory navicular bone incidence in Chinese patients: a retrospective analysis of X-rays following trauma or progressive pain onset. Surg Radiol Anat 2014;36(2):167-72.
Apostle KL, Sangeorzan BJ. Anatomy of the varus foot and ankle. Foot Ankle Clin 2012;17:1-11.
Nwawka OK, Hayashi D, Diaz LE, et al. Sesamoids and accessory ossicles of the foot: anatomical variability and related pathology. Insights Imaging 2013;4:581-93.
Sarin VK, Erickson GM, Giori NJ, et al. Coincident development of sesamoid bones and clues to their evolution. Anat Rec 1999;257:174-80.
Kruse RW, Chen J. Accessory bones of the foot: clinical significance. Mil Med 1995;160:464-7.
Coskun N, Yuksel M, Cevener M, et al. Incidence of accessory ossicles and sesamoid bones in the feet: a radiographic study of the Turkish subjects. Surg Radiol Anat 2009;31:19-24.
Mellado JM, Ramos A, Salvado E, et al. A. Accessory ossicles and sesamoid bones of the ankle and foot: imaging findings, clinical significance and differential diagnosis. Eur Radiol 2003;13 Suppl 6:L164-77.
MJC. Sesamoid and accessory bones of the foot. In: Coughlin MJ edition. Surgery of the foot and ankle. 2006.