Os calcaneus secundarius

An os calcaneus secundarius is an accessory ossicle of the anterior calcaneal process present in up to 5% of the population at cadaveric examination. The ossicle can be a cause of ankle pain and may mimic bifurcate ligament avulsion fracture of the anterior calcaneal process.

Differential diagnosis

The main differential diagnosis is a fracture of the anterior process of the calcaneus. It could be difficult to distinguish it from an os calcaneus secundarius, especially if the suspected fracture is subacute or chronic in nature.

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