Acquired cavo-varus deformity caused by an accessory calcaneus: a case report and literature review
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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.
KeywordsAccessory calcaneus Cavo-varus Ossicle Arthroereisis
No funding was required for the preparation of this report.
- 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.Sarrafian SK. Anatomy of the foot and ankle: descriptive, topographic, functional. 2nd ed. Philadelphia: Lippincott Williams & Wilkins;1993.Google Scholar
- 4.Ogden JA. Skeletal injury in the child. 3rd ed. Basel: Birkhäuser; 2000. p. 1094.Google Scholar
- 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.Trolle D. Accessory bones of the human foot. Copenhagen: Munksgaard; 1948. pp. 2–53.Google Scholar
- 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