Sesamoids and accessory ossicles are frequently encountered normal osseous structures in the foot that may be an uncommon cause of pain. Familiarity with their imaging findings allows the radiologist to provide reassurance in normal cases and increase confidence when making the relatively uncommon diagnosis of a pathologic sesamoid or symptomatic ossicle. Image-guided injections targeted to the symptomatic ossicle can confirm the suspected diagnosis and predict therapeutic outcomes before surgical intervention.
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