The patient was a 14-year-old female with a 4-year history of left anterolateral foot and ankle pain of insidious onset that was first noticed while playing soccer. After a lack of progress with conservative measures for her left foot and ankle pain, the patient was evaluated by an orthopaedic surgeon. While conventional radiographs of the foot and ankle were normal, magnetic resonance imaging revealed generalized bone marrow edema in the navicular bone with irregularity along the lateral margin of the navicular bone and adjacent anterior margin of the anterior process of the calcaneus. These findings suggested possible sequelae of osteonecrosis or a partial coalition between the lateral margin of the navicular bone and anterior process of the calcaneus. Computed tomography scanning revealed focal osteochondral bone changes along the lateral margin of the navicular bone and anterior process of the calcaneus. Surgery was performed 3 months later, which involved excision of a fibrous calcaneonavicular tarsal coalition.

J Orthop Sports Phys Ther 2010;40(9):596. doi:10.2519/jospt.2010.0415

KEY WORDS: ankle, computed tomography, foot, magnetic resonance imaging