The os calcis secundarius is a rare accessory ossicle located on the superior-anterior surface of the calcaneus near the talonavicular joint. It is present in less than 1 percent of the population and is usually an incidental radiographic finding. Occasionally it can produce sinus tarsi-type symptoms from compression within the tarsal sinus.
The os calcis secundarius is almost always asymptomatic and requires no treatment. When symptomatic it produces lateral midfoot pain in the sinus tarsi region and may be mistaken for an avulsion fracture on radiograph. CT confirms the well-corticated margins of a normal ossicle versus the irregular margins of acute fracture.
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