Bilateral type II accessory navicular bone (os naviculare) is noted, with subchondral marrow edema on the left one reflecting accessory navicular syndrome. Usually presents with pain on the medial aspect of the foot over the ossicle area.

The diagnosis could be suspected first if the pain radiograph shows type II accessory navicular bone which is a normal variant. MRI confirms the diagnosis by showing subchondral edema and high T2 signal at the synchondrosis.

Case courtesy; Dr Rim Bastawy, Lecturer of radiodiagnosis, Alexandria University, Egypt.