The Cause of Pain in Symptomatic Accessory Navicular Syndrome : comparison between Athletes and Non-Athletes

Transcription

1 The Cause of Pain in Symptomatic Accessory Navicular Syndrome : comparison between Athletes and Non-Athletes Kyung Tai Lee, M.D., Young Uk Park, M.D. *, Hyuk Jegal, M.D., Young Tae Rho, M.D. KT Lee s Orthopedic Foot & Ankle Clinic, Seoul, Korea Department of Orthopedic Surgery, Ajou University Hospital, Suwon, Korea*

2 The Cause of Pain in Symptomatic Accessory Navicular Syndrome : comparison between Athletes and Non-Athletes Kyung Tai Lee, M.D., Young Uk Park, M.D., Hyuk Jegal, M.D., Young Tae Rho, M.D. My disclosure is in the Final AOFAS Program Book. I have no potential conflicts with this presentation.

3 Introduction Many theories have been put forth to explain the role of an accessory navicular as a pain generator in the foot But there were few literature that reported the radiologic Cause of pain, especially, focusing on athletic population. The Purpose of this study To Evaluate the Radiologic Cause of Pain in the Athletes with Accessory Navicular Syndrome who underwent Surgery for continuing pain after 3 months of conservative treatment on comparison with that in the non-athletes

4 Material & Methods (I)

5 Material & Methods(II)

6 Ankle sprain / classification Results ( I ) Simple X-ray ankle sprain 36/64 (56.3%) / type II in All 26% 74% Ankle sprain Ankle sprain In Athletes 39% 61% In non-athletes P=0.006, Fisher s exact test Size of Accessory navicular bone Length & width measured athlete group 11.17±4.95 mm 7.22±2.37 mm non-athlete group 13.79±5.14mm 8.41±2.66 mm P=0.117, p=0.170, independent sample t-test Conccurent flatfoot deformity Total 20 feet of 64 feet 8 of 31 feet in Athlete group 12 of 33 feet in Non-Athlete group P=0.59, Fisher s exact test

7 Results ( II ) Ultrasound All the patients were checked by ultrasound Diastasis between Navicular and Accessory navicular 42% 58% Diastasis Diastasis In Athletes 33% 67% In non-athletes P=0.047, Pearson s chi square test Pathologic posterior tibial tendon 3 of 31 feet in Athlete group 4 of 33 feet in Non-Athlete group

8 Results ( III ) MRI Fat-suppressed T2 weighted sequences checked in 57 bone marrow edema 47 of 57 (82.5%) 10% BM (-) 90% BM edema 27 of 30 feet both bone edema : all In Athletes MRI checked in 30 feet bone edema 27 of 30 feet ( navicular & accessory : all of 27 feet) A. navicular bone +/ AN bone + : 43 B. navicular bone - /AN bone + : 4 C. navicular bone +/AN bone - : 0 D. navicular bone - /AN bone - : 10 tendon signal change : only one in 57 feet 15% BM (-) 26% Only AN 4 of 20 feet In Non-Athletes Both BM edema 16 of 20 feet 59% MRI checked in 27 feet bone edema 20 of 27 feet ( navicular & accessory : 16 of 20 feet only accessory : 4 of 20 feet ) No significant difference in the presence of bone edema P=0.167, Fisher s exact test Significant difference in BM edema in both AN & Navicular P=0.012, Fisher s exact test

9 Discussion(I)

10 Discussion(II)

11 Conclusion

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