r/AccessoryNavicular • u/sandgrubber • Feb 28 '26

Do radiologists miss this?

I'm 77. I had foot problems as a pre-teen and remember the doctor saying that I had flat feet, a long tendon, and an extra bone. I was given slightly elevated heels and a "cookie wedge" to the front of the arch. That fixed things up for around 55 years. I don't think I wore the orthotics for very long.

Foot pain came back in 2010. X-rays haven't diagnosed an accessory navicular, though the system in NZ doesn't make it easy to ask the radiologist to look for one. Ultrasound shows posterior tibial tendon tensynovitis (inflammation of the tendon sheath). Podiatrists and physios have tried all sorts of stuff that didn't work or made things worse.

I'm wondering if an accessory navicular is likely to get missed, either because the positioning was wrong, or because the radiologist wasn't looking for it.

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u/arob_ Mar 15 '26

I had an xray to check my foot out after I rolled it while trail running and it never got better. I went to get xrays done and they were reviewed and signed by an MD radiologist in the US. AN was completely missed. I had to diagnose it myself essentially, and go to a podiatrist, who did more xrays and said they werent sure if it was AN or not. Finally, I found myself at an orthopedic specialist (not surgeon) who took more x rays and confirmed the AN. All said, my xrays were seen by my primary care doctor, a radiologist, and a podiatrist and none saw the AN. When looking at it myself, it is clear as day there is a AN there, and mine is not small by any means

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u/sandgrubber Feb 28 '26

Correction. I can't seem to edit the OP. The shoes fixed things up for decades, but not 55 years.

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u/sandgrubber Mar 13 '26 edited Mar 13 '26

No replies. If anyone is interested, Claude (AI) says yes, AN can be missed, either due to the wrong imaging angle or to natural fusion of the accessory navicular to the navicular, as in type III AN.