Introduction Navicular stress fractures are frequently encountered in athletes.
Navicular stress fractures are frequently encountered in athletes. First described by Town in 1970, they represent up to โ of all stress fractures and are almost exclusively seen in athletes (98%). Stress fractures are an overuse syndrome where repetitive foot strikes during exercise or running result in microfractures with inadequate rest and recovery time.
The navicular is particularly susceptible due to the middle โ being relatively avascular. As a side note, Mueller-Weiss syndrome is a rare presentation of navicular avascular necrosis seen in middle aged adults with chronic midfoot pain which can present similarly. Clinical Vignette You are evaluating a 37 year old long distance runner who presents with an insidious onset of mid foot pain.
She has rapidly increased her distance as she trains for an ultra marathon. The pain is located at her midfoot where she has point tenderness over the dorsomedial foot. Which of the following imaging modalities has the highest diagnostic yield for the most likely diagnosis?
A) Radiographs B) CT C) MRI D) Ultrasound Anatomy of the foot with the navicular bone highlighted in red (click to enlarge). Navicular stress fractures are most commonly seen in track and field athletes, who account for 59% of navicular stress fractures, as well as runners and basketball players. Other risk factors are similar to those associated with general stress fractures including history of stress fractures, female athlete triad, relative energy deficiency in sport, poor nutritional status, excessive training, poor footwear or biomechanics.[ref]Wright AA, Taylor JB, Ford KR, Siska L, Smoliga JM.
If you are experiencing symptoms that may be related to a navicular stress fractures, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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