Navicular fractures of the foot can occur from direct trauma to the foot, falls from heights, and repetitive stress on the navicular bone (in the case of a navicular stress fracture).
Tarsal navicular fractures can sometimes be difficult to diagnose and are often missed. An accurate diagnosis of the injury is important to ensure a successful recovery.
In this article, we’ll discuss how navicular foot fractures are commonly diagnosed.
Diagnosis of Navicular Fractures
Symptoms of a navicular foot fracture include pain and swelling along the inner midfoot. If you suspect that you have a navicular stress fracture, you should visit your local foot doctor’s office. Your doctor will perform a physical exam and order x-rays of the foot.
X-Ray
X-rays of the foot can be done at your doctor’s office. An x-ray can help identify whether the fracture is nondisplaced (fracture is in appropriate alignment) or displaced (fracture fragments are shifted).
An x-ray can show if the navicular bone is dislocated and no longer aligning with its joint spaces. An x-ray can also identify the presence of any adjacent broken bones.
X-rays can help identify the presence of navicular body fractures, navicular avulsion fractures, and navicular stress fractures, and also whether these fractures are comminuted (fracture fragment has more than two pieces).
MRI Exam
If x-rays appear normal and your doctor suspects that a navicular fracture is present, they may recommend a Magnetic Resonance Imaging (MRI) exam.
An MRI exam is useful in identifying the fracture as well as any dislocation that may be present. An MRI can also help identify the presence of a soft tissue injury as well. In the case of a navicular fracture, an MRI would show the presence of a fracture line, as well as bone edema. It is a non-invasive procedure and can be done within 1 hour.
CT Scan
A Computed Tomography Scan (CT scan) can be ordered to diagnose a navicular fracture.
CT scans use x-ray technology, but the images are much more detailed and can show even the smallest fractures. It can help identify the size and shape of the fracture, and provide detailed images of how much of the bone is affected.
This is valuable information for the surgeon and can help prepare the surgeon for what to expect during surgery.
Bone Scan
Navicular foot fractures can be identified via a bone scan. A small amount of radioactive material is injected into the bloodstream and then absorbed by the bones. The material accumulates in areas of increased activity.
An image is produced that shows the increased area of activity, confirming the presence of a fracture. Bone scans are painless and can be completed in one day.
Diagnosing a Navicular Stress Fracture
Stress fractures typically occur due to repetitive stress on the bones over time. Unlike acute navicular fractures, navicular stress fractures can be difficult to diagnose initially.
Stress fractures can take up to three weeks to show up on a plain film x-ray. In the case of a stress fracture, your doctor may recommend ordering an MRI, CT scan, or bone scan in addition to an x-ray
A nondisplaced navicular stress fracture can be treated conservatively. However, a displaced fracture may require surgery.
It is important to follow the doctor’s instructions and seek prompt treatment for suspected navicular stress fractures to prevent further injury and promote healing.
Conclusion
Identifying a tarsal navicular bone fracture as soon as possible can help expedite treatment and the overall healing process. Navicular injuries can be painful, and should not be ignored. If you suspect your foot is broken, contact your local foot doctor.
Related post: Pediatric Navicular Fractures- How To Diagnose and Treat Them
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