The navicular tuberosity is the rounded projection on the medial side of the navicular bone, palpable about 2-3 cm in front of and below the medial malleolus. It is the main insertion of the tibialis posterior tendon and supports the medial longitudinal arch.
| Articulations |
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|---|---|
| Landmarks |
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| Ossification | Part of the navicular, which ossifies at about 2-4 years; a separate secondary centre at the tuberosity appearing at about 9-11 years may fail to fuse, forming an accessory navicular. |
The navicular tuberosity is used to measure arch height and navicular drop in assessing flat foot. Tibialis posterior tendon dysfunction weakens the medial arch and is the commonest cause of acquired adult flat foot. An accessory navicular beside the tuberosity can become painful in adolescents and active adults.
Find the medial malleolus and move about 2-3 cm forward and down along the inner side of the midfoot. The most prominent bony bump there is the navicular tuberosity; following the tibialis posterior tendon from behind the malleolus leads straight to it. It is the reference point for measuring navicular drop.
Eversion injury or violent tibialis posterior contraction avulses the tuberosity, causing medial midfoot pain.
Stress at the junction between an accessory navicular and the tuberosity causes a tender medial bump, often aggravated by shoes.
Degeneration of the tendon near its insertion on the tuberosity leads to medial ankle pain and progressive flat foot.
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