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Stress fracture of the tarsal navicular

Little attention has been been given in the literature to stress fractures of the tarsal navicular. The diagnosis is infrequently made, although this entity is probably more common than recognized. Unlike other stress fractures, the pain may be vague and diffuse in nature. One key to differentiating this entity from overuse syndromes is that the pain, like the pain in other stress fractures, increases during activity, not following it, as seen with many overuse syndromes. Roentgenographs may not be diagnostic, so one must use bone scans or tomograms for verification. Recognition is extremely important because continued activity may result in a displaced intraarticular fracture.