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Portrait of Navicular bone

Anatomy · Bones

Navicular bone

The boat-shaped bone of the foot

Foot · midfoot · tarsal bones

The navicular is the boat-shaped tarsal bone on the inner side of the foot, lying between the head of the talus behind and the three cuneiform bones in front. It is the keystone of the medial longitudinal arch, and its tuberosity, a palpable bump on the inner border of the foot, is the main insertion of tibialis posterior. It is the last of the tarsal bones to begin to ossify.

How to spot them

  • ▸Flattened, boat-shaped bone on the inner border of the foot, between the talus and the three cuneiforms
  • ▸Concave, oval back surface receiving the head of the talus; three triangular facets in front for the cuneiforms
  • ▸A prominent tuberosity on the inner side, palpable about 2.5 cm in front of and below the medial malleolus
  • ▸Sometimes a small facet on its outer side meets the cuboid

What to know

A boat-shaped bone on the inner side of the foot, between the head of the ankle bone and three wedge-shaped bones

Navicular bone — the boat-shaped tarsal bone (navicula, little ship).

The keystone of the arch on the inner border of the foot

Navicular bone — it maintains the medial longitudinal arch.

A prominent bump on the inner border of the foot, about 2.5 cm in front of the ankle's inner bump, is where the main tendon of the deep calf muscle inserts

Navicular bone — the navicular tuberosity, insertion of tibialis posterior.

The last of the bones of the hindfoot and midfoot to begin ossifying, appearing around the third year

Navicular bone — the last tarsal bone to ossify.

A childhood condition in which its ossification centre is starved of blood, flattening and hardening it on X-ray, is named after a German radiologist, Köhler

Navicular bone — Köhler disease (avascular necrosis).

An extra ossicle at its inner border, present in about one person in twenty, can be mistaken for a fracture

Navicular bone — the accessory navicular (os naviculare, os tibiale externum).

Stress fractures of its central third, a poorly vascularised zone, are a problem of sprinters and jumpers

Navicular bone — the 'N spot' stress fracture.

Its name, a boat, matches a bone of the wrist with the Greek equivalent, which was once called by this Latin name too

Navicular bone — the hand's scaphoid, once the os naviculare manus.

Key ideas

  • It transmits force from the talus to the three cuneiforms and so to the medial three metatarsals, and helps maintain the medial longitudinal arch; failure of the tibialis posterior tendon at its insertion contributes to flat foot.
  • It is the intermediate bone of the tarsus: in the carpus there are two rows of four, but in the tarsus the navicular is interposed between the proximal and distal rows on the medial side.

Quick-fire facts

  • •The navicular is boat-shaped (Latin navicula, a small ship) and is sometimes called the tarsal scaphoid.
  • •It articulates with the head of the talus behind, the three cuneiforms in front, and often the cuboid on its outer side.
  • •The tibialis posterior tendon inserts mainly on its tuberosity, with slips to the cuneiforms, cuboid and middle three metatarsals.
  • •The navicular tuberosity is palpable about 2.5 cm distal to the medial malleolus.
  • •The ossification centre of the navicular appears in about the third year of life, the last of the tarsals.
  • •An accessory navicular occurs in roughly 5% of people (Kenhub); it can cause pain at the inner arch.
  • •Köhler disease, described in 1908 by the German radiologist Alban Köhler, is childhood avascular necrosis of the navicular, usually in boys aged about 4–7.
  • •Müller–Weiss disease is spontaneous avascular necrosis of the navicular in adults.

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Sources