Quiz case. Symptomatic type II accessory navicular.

A 17 year old boy, who twisted his left foot while playing soccer a few days earlier, presented with pain and swelling along the medial aspect of the left foot. Clinical examination revealed an area of swelling and tenderness anteroinferiorly to the medial malleolus. Radiographs were considered normal and the patient was treated with a topical anti-inflammatory agent. During the following seven months the patient continued to experience pain on the medial side of the left foot, especially after a prolonged activity and when putting on shoes. Focal redness and tenderness was also evident.