Accessory Ossicles in the Region of the Foot and Ankle: An Epidemiologic Survey in a Jordanian Population

<i>Background and Objectives</i>: The incidence of accessory bones in the region of foot and ankle is quite variable between studies and are often confused with avulsion fractures in trauma patients with musculoskeletal injuries. The aim of this study was to assess the incidence of acces...

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Autores principales:	Heba Kalbouneh, Omar Alajoulin, Jamil Shawaqfeh, Ayman Mustafa, Shehab Jaber, Shaima’ Zaben, Ja’far Zapen, Mohammad Alsalem
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	accessory ossicle incidence foot radiology Jordanians ankle anatomy Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/4e47d13c9c7f4c468c3fde4f65524f0a
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spelling	oai:doaj.org-article:4e47d13c9c7f4c468c3fde4f65524f0a2021-11-25T18:18:21ZAccessory Ossicles in the Region of the Foot and Ankle: An Epidemiologic Survey in a Jordanian Population10.3390/medicina571111781648-91441010-660Xhttps://doaj.org/article/4e47d13c9c7f4c468c3fde4f65524f0a2021-10-01T00:00:00Zhttps://www.mdpi.com/1648-9144/57/11/1178https://doaj.org/toc/1010-660Xhttps://doaj.org/toc/1648-9144<i>Background and Objectives</i>: The incidence of accessory bones in the region of foot and ankle is quite variable between studies and are often confused with avulsion fractures in trauma patients with musculoskeletal injuries. The aim of this study was to assess the incidence of accessory ossicles of the foot and ankle according to gender, side and coexistence, and to determine how frequently accessory ossicles were misdiagnosed as avulsion fractures. <i>Materials and Methods</i>: Oblique and/or lateral foot radiographs of 1000 adult patients referred from emergency departments to foot and ankle clinic were retrospectively reviewed for the presence of accessory ossicles. The Kappa statistic was used in order to assess the validity of radiographic interpretation for the presence of these bones. <i>Results</i>: Accessory ossicles were detected in 40.2% of the radiographs. The incidence rates for the accessory ossicles in order of frequency were: Os trigonum (15.4%), accessory navicular (13.7%), os peroneum (11.5%), os vesalianum (1.1%), os supranaviculare (0.7%), os subfibulare (0.6%), os talotibiale (0.4%), os calcaneus secundarius (0.3%), os supratalare (0.3%), os infranaviculare (0.3%), os intermetatarseum (0.2%), and os subtibiale (0.1%). Coexistence of two or three ossicles in the same foot was observed in 4.4% of the cases, mostly coexistence with os peroneum (2.9%), followed by accessory navicular (1.6%). 2.7% of accessory ossicles were initially misdiagnosed as avulsion fractures at emergency departments. Interrater agreement over identification of different accessory ossicles was found to be reasonably reliable, with a Kappa greater than 0.80 for all assessed bones. <i>Conclusions</i>: In clinical practice, a thorough knowledge of normal anatomical variants is essential to facilitate appropriate diagnosis and treatment and can help to prevent diagnostic errors.Heba KalbounehOmar AlajoulinJamil ShawaqfehAyman MustafaShehab JaberShaima’ ZabenJa’far ZapenMohammad AlsalemMDPI AGarticleaccessory ossicleincidencefoot radiologyJordaniansankleanatomyMedicine (General)R5-920ENMedicina, Vol 57, Iss 1178, p 1178 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	accessory ossicle incidence foot radiology Jordanians ankle anatomy Medicine (General) R5-920
spellingShingle	accessory ossicle incidence foot radiology Jordanians ankle anatomy Medicine (General) R5-920 Heba Kalbouneh Omar Alajoulin Jamil Shawaqfeh Ayman Mustafa Shehab Jaber Shaima’ Zaben Ja’far Zapen Mohammad Alsalem Accessory Ossicles in the Region of the Foot and Ankle: An Epidemiologic Survey in a Jordanian Population
description	<i>Background and Objectives</i>: The incidence of accessory bones in the region of foot and ankle is quite variable between studies and are often confused with avulsion fractures in trauma patients with musculoskeletal injuries. The aim of this study was to assess the incidence of accessory ossicles of the foot and ankle according to gender, side and coexistence, and to determine how frequently accessory ossicles were misdiagnosed as avulsion fractures. <i>Materials and Methods</i>: Oblique and/or lateral foot radiographs of 1000 adult patients referred from emergency departments to foot and ankle clinic were retrospectively reviewed for the presence of accessory ossicles. The Kappa statistic was used in order to assess the validity of radiographic interpretation for the presence of these bones. <i>Results</i>: Accessory ossicles were detected in 40.2% of the radiographs. The incidence rates for the accessory ossicles in order of frequency were: Os trigonum (15.4%), accessory navicular (13.7%), os peroneum (11.5%), os vesalianum (1.1%), os supranaviculare (0.7%), os subfibulare (0.6%), os talotibiale (0.4%), os calcaneus secundarius (0.3%), os supratalare (0.3%), os infranaviculare (0.3%), os intermetatarseum (0.2%), and os subtibiale (0.1%). Coexistence of two or three ossicles in the same foot was observed in 4.4% of the cases, mostly coexistence with os peroneum (2.9%), followed by accessory navicular (1.6%). 2.7% of accessory ossicles were initially misdiagnosed as avulsion fractures at emergency departments. Interrater agreement over identification of different accessory ossicles was found to be reasonably reliable, with a Kappa greater than 0.80 for all assessed bones. <i>Conclusions</i>: In clinical practice, a thorough knowledge of normal anatomical variants is essential to facilitate appropriate diagnosis and treatment and can help to prevent diagnostic errors.
format	article
author	Heba Kalbouneh Omar Alajoulin Jamil Shawaqfeh Ayman Mustafa Shehab Jaber Shaima’ Zaben Ja’far Zapen Mohammad Alsalem
author_facet	Heba Kalbouneh Omar Alajoulin Jamil Shawaqfeh Ayman Mustafa Shehab Jaber Shaima’ Zaben Ja’far Zapen Mohammad Alsalem
author_sort	Heba Kalbouneh
title	Accessory Ossicles in the Region of the Foot and Ankle: An Epidemiologic Survey in a Jordanian Population
title_short	Accessory Ossicles in the Region of the Foot and Ankle: An Epidemiologic Survey in a Jordanian Population
title_full	Accessory Ossicles in the Region of the Foot and Ankle: An Epidemiologic Survey in a Jordanian Population
title_fullStr	Accessory Ossicles in the Region of the Foot and Ankle: An Epidemiologic Survey in a Jordanian Population
title_full_unstemmed	Accessory Ossicles in the Region of the Foot and Ankle: An Epidemiologic Survey in a Jordanian Population
title_sort	accessory ossicles in the region of the foot and ankle: an epidemiologic survey in a jordanian population
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/4e47d13c9c7f4c468c3fde4f65524f0a
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Accessory Ossicles in the Region of the Foot and Ankle: An Epidemiologic Survey in a Jordanian Population

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