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How to increase the accuracy of the diagnosis of the accessory bone of the foot?

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Abstract

Purpose

The study was conducted to search for confident radiological signs in symptomatic cases of accessory bones. A normal accessory bone appearance on X-ray does not exclude that the accessory bone is the source of the discomfort; because of this, MRI examination can later be applied as part of the diagnosis.

Methods

We retrospectively analysed cases of 64 patients with recognized 70 symptomatic accessory bones of the foot. The average age was 29.2 (range 8–42) years. We included only patients with X-ray and MRI examinations. We investigated the following radiological features of the bone (structural and signal) in relation to soft tissue.

Results

The most constant symptoms identified in our study were bone marrow oedema (93%) and soft tissue oedema (77%). Changes in structures in which accessory bones were located or in adjacent structures to accessory bone were identified: tendon changes 51%, fluid adjacent to bone 51% and tenosynovitis 46%. MRI revealed changes in bone structure that are not seen on X-ray, including changes in contour (28%), sclerosis (3%) or osteonecrosis (3%).

Conclusions

MRI plays an important role in determining whether accessory bones cause symptoms because it shows specific and accurate changes in accessory bone and/or in adjacent soft tissue.

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Authors and Affiliations

  1. Sahlgrenska Universitetssjukhuset - Mölndals Sjukhus, Göteborgsvägen 31, 431 30, Göteborg, Sweden

    Paweł Szaro

  2. Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland

    Paweł Szaro

  3. Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland

    Paweł Szaro & Mateusz Polaczek

  4. Department of Orthopaedics, Medical University of Warsaw, Warsaw, Poland

    Jan Świątkowski & Hanna Kocoń

Authors
  1. Paweł Szaro
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  2. Mateusz Polaczek
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  3. Jan Świątkowski
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  4. Hanna Kocoń
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by PS, MP, HK and JS. The first draft of the manuscript was written by PS, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Paweł Szaro.

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Conflict of interest

None of the authors declare a conflict of interest.

Ethical approval

The Institutional Ethics Committee was informed about the ongoing study, and the Committee stated no need for its approval (Number AKBE257/2019).

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Szaro, P., Polaczek, M., Świątkowski, J. et al. How to increase the accuracy of the diagnosis of the accessory bone of the foot?. Radiol med 125, 188–196 (2020). https://doi.org/10.1007/s11547-019-01104-x

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  • DOI: https://doi.org/10.1007/s11547-019-01104-x

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