Foot: accessory navicular: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Foot: accessory navicular

Sample item

A 12-year-old girl has pain and a bony prominence on the medial border of the midfoot that is aggravated by tight shoes. Radiographs show a separate ossicle attached to the navicular tuberosity, and the tibialis posterior tendon inserts into it. What is the likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Accessory navicular

An accessory navicular is an extra ossicle at the medial navicular tuberosity, present in a minority of people. It may become painful from shoe pressure or traction of tibialis posterior and is often associated with flatfoot. Management is with padding, orthoses and rest, and excision for persistent symptoms.

Option by option

  • A. Sever disease

    Sever disease is calcaneal apophysitis.

  • B. Accessory navicular (correct)

    Correct. A medial navicular ossicle with tibialis posterior insertion is an accessory navicular.

  • C. Kohler disease

    Kohler disease is avascular necrosis of the whole navicular in young boys.

  • D. Freiberg infraction

    Freiberg infraction is avascular necrosis of the second metatarsal head.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Accessory navicular. An accessory navicular is an extra ossicle at the medial navicular tuberosity, present in a minority of people.

Why is "Sever disease" not the answer?

Sever disease is calcaneal apophysitis.

Why is "Kohler disease" not the answer?

Kohler disease is avascular necrosis of the whole navicular in young boys.

Why is "Freiberg infraction" not the answer?

Freiberg infraction is avascular necrosis of the second metatarsal head.

What concept does this question test?

It tests Foot: accessory navicular in Orthopaedics. It may become painful from shoe pressure or traction of tibialis posterior and is often associated with flatfoot. Management is with padding, orthoses and rest, and excision for persistent symptoms.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Foot: accessory navicular?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.