Nuclear Medicine and Molecular Imaging

, Volume 50, Issue 4, pp 322–328 | Cite as

Clinical Meaning of Hot Uptake on Bone Scan in Symptomatic Accessory Navicular Bones

  • Ari Chong
  • Jung-Min HaEmail author
  • Jun-Young Lee
Original Article



We analyzed clinical factors related to uptake on a Tc-99 m HDP bone scan of the accessory navicular (AN).

Materials and Methods

We retrospectively reviewed patients who had been examined by an orthopedic surgeon and underwent bone scan due to suspected symptomatic AN. A three-point grading system was used to evaluate uptake on bone scan. Relationships between grade, symptoms, age, gender, symptom duration, and bone size were analyzed.


In total, 73 ANs (30 asymptomatic, 43 symptomatic) were enrolled. The majority of asymptomatic ANs had no uptake but some had grade 1 (n = 8) or 2 (n = 2) uptake. All asymptomatic ANs with uptake remained asymptomatic during follow-up. For the asymptomatic ANs, larger bones showed a higher grade. With a cut-off value of size ≤6.8 mm, there is no chance of uptake. All symptomatic ANs showed uptake on bone scan. For symptomatic ANs, larger size and shorter pain duration were related to a higher grade. Age, gender, and left-/right-sideness were not related to grade. Multiple regressions revealed that only uptake grade, not size or symptom duration, was the significant risk factor for a symptomatic AN. With a cut-off value of grade <1, a symptomatic AN could be ruled out with a negative predictive value of 100 %.


Bone scanning is useful for symptomatic ANs with a high negative predictive value. Higher grade is related to larger size and shorter pain duration. For asymptomatic ANs, grade was related to size but did not predict symptom development.


Accessory navicular bone Emission-computed Radionuclide imaging Tomography 



This study was supported by research fund from Chosun University, 2013

Compliance with Ethical Standards

Conflict of Interest

Ari Chong, Jung-Min Ha and Jun-Young Lee declare that they have no conflict of interests.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

The institutional review board of our institute approved this retrospective study, and the requirement to obtain informed consent was waived.


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Copyright information

© Korean Society of Nuclear Medicine 2016

Authors and Affiliations

  1. 1.Department of Nuclear MedicineChosun University HospitalGwangjuRepublic of Korea
  2. 2.Department of Orthopaedic Surgery, Foot and Ankle SurgeryChosun University HospitalGwangjuRepublic of Korea

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