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Skeletal Radiology

, Volume 39, Issue 2, pp 193–197 | Cite as

Acquired cavo-varus deformity caused by an accessory calcaneus: a case report and literature review

  • Davinder Paul Singh BaghlaEmail author
  • Sajid Shariff
  • Waseem A. Bashir
Case Report

Abstract

We describe an unusual cause of an acquired cavo-varus foot deformity produced by progressive enlargement of an accessory calcaneal ossicle. A 13-year-old boy with constitutional plano-valgus flat feet noted a gradual change in foot shape associated with lateral ankle pain on ambulation following an inversion injury 2 years earlier. CT and MRI scans confirmed a large accessory calcaneal ossicle lying within the sinus tarsi, with associated marrow oedema. Following surgical excision of the ossicle, the foot returned to its original shape and the symptoms were alleviated. This is the fifth reported case of an accessory calcaneal ossicle, but the only case that has occurred in a flatfooted individual. We also present the first reported MRI images of the lesion confirming pathological marrow oedema as a response to mechanical stress.

Keywords

Accessory calcaneus Cavo-varus Ossicle Arthroereisis 

Notes

Acknowledgement

No funding was required for the preparation of this report.

References

  1. 1.
    Coughlin MJ. Sesamoids and accessory bones of the foot. In: Mann RA, Coughlin MJ, editors. Surgery of the foot and ankle. 8th ed. St. Louis: Mosby; 2007.Google Scholar
  2. 2.
    Sarrafian SK. Anatomy of the foot and ankle: descriptive, topographic, functional. 2nd ed. Philadelphia: Lippincott Williams & Wilkins;1993.Google Scholar
  3. 3.
    O'Rahilly R. A survey of carpal and tarsal anomalies. J Bone Joint Surg. 1953;35:626–42.CrossRefGoogle Scholar
  4. 4.
    Ogden JA. Skeletal injury in the child. 3rd ed. Basel: Birkhäuser; 2000. p. 1094.Google Scholar
  5. 5.
    Pfitzner W. Beitrage zur Kenntniss des menschlichen Extremitatenskelets. VII. Die Variationen im Aufbau des Fusskelets. In: Schwalbe G, editor. Morphologische Arbeiten, vol 6. Jena: Fischer; 1896.Google Scholar
  6. 6.
    Trolle D. Accessory bones of the human foot. Copenhagen: Munksgaard; 1948. pp. 2–53.Google Scholar
  7. 7.
    Cormier-Daire V, Savarirayan R, Unger S, Rimoin DL, Lachman RS. "Duplicate calcaneus": a rare developmental defect observed in several skeletal dysplasias. Pediatr Radiol. 2001;31(1):38–42.CrossRefGoogle Scholar
  8. 8.
    Freyschmidt J, Köhler A, Zimmer EA, Brossmann J, Sternberg A, Wiens J, Schmidt H. Freyschmidt's "Koehler/Zimmer" borderlands of normal and early pathologic findings in skeletal radiography. 5th ed. Stuttgart: Thieme; 2003.Google Scholar
  9. 9.
    Hirschtick AB. An anomalous tarsal bone. J Bone Joint Surg Am. 1951;33:907–10.CrossRefGoogle Scholar
  10. 10.
    Uhrbrand B, Jensen T. A case of accessory calcaneus. Acta Orthop Scand. 1986;57(5):455.CrossRefGoogle Scholar
  11. 11.
    Krause J, Rouse A. Accessory calcaneus: a case report and literature review. Foot Ankle Int. 1995;16(10):646–50.CrossRefGoogle Scholar
  12. 12.
    Wünschel M, Wülker N, Kluba T. Progressive pes adductus caused by an accessory calcaneus: a case report. Foot Ankle Int. 2007;28(7):838–40.CrossRefGoogle Scholar
  13. 13.
    Needleman Rl. A surgical approach for flexible flatfeet in adults including a subtalar arthroereisis with the MBA sinus tarsi implant. Foot Ankle Int. 2006;27(1):9–18.CrossRefGoogle Scholar

Copyright information

© ISS 2009

Authors and Affiliations

  • Davinder Paul Singh Baghla
    • 1
    Email author
  • Sajid Shariff
    • 2
  • Waseem A. Bashir
    • 3
  1. 1.Orthopaedic DepartmentEaling HospitalSouthallUK
  2. 2.Orthopaedic DepartmentWexham Park HospitalSloughUK
  3. 3.Radiology DepartmentEaling HospitalSouthallUK

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