Mueller-Weiss Syndrome of the Tarsal Navicular

The Mueller Weiss disorder is a infrequent source of pain in the midfoot in adults that has been also referred to as Brailsford disease. It is a sudden onset osteonecrosis of the tarsal navicular within the foot. There’s a a lot more well-known condition of the navicular in young childen known as Köhler disease, which is also an osteonecrosis in the tarsal navicular bone, but they are completely different disorders because of the nature of the developing bones in children. The disease was initially reported by Schmidt in1925. Then it was W Muller who later supposed how the underlying mechanism in the disorder has been as a result of an abnormal compressive power in the mid-foot area. Around the same period, K Weiss, reported that the look on x-ray were similar to those seen in a disorder known as Kienbock disease, and this is an osteonecrosis. Those two reports resulted in the most frequently used term for this disease, Mueller Weiss syndrome.

Mueller Weiss syndrome commonly occurs in adults between 40 and 60 years of age (Köhler disease has a common onset around five years of age). Mueller Weiss disease appears to be more prevalent in females. It might have an impact on only one foot, or it might affect both feet. The classic symptoms include the progressive oncoming of pain in the mid-foot and rearfoot which may turn out to be localized to the most painful area being around the navicular bone. A flat foot is in addition more prevalent in people that have this condition. The gold standard to identify Mueller Weiss syndrome is via using radiology. On x-ray there will appear to be a collapse of parts of the bone and a whiteness and a comma-shaped deformity in the lateral aspect. A CT scan may present the same irregularities and can be helpful to look at the stage of the problem in additional detail. A MRI is often a lot more sensitive to assist with the verification since it is able to detect a change in the bone tissues.

Mueller Weiss disease is often progressive and may result in acute pain and become somewhat debilitating, so treatment does need to be started as early as possible in order to avoid the navicular from being impaired too much. Initial treatment is to reduce weight bearing, possibly some pain alleviation medications and use supporting footwear. Generally foot orthotics are widely used to help further stabilise the area and support the arch of the foot. This keeps a lot of strain off of the navicular bone. If that is not necessarily helping, after that further reduction in exercise amounts is essential so there is much less stress on the painful spot. A moon boot or walking brace will be the next step to further protect as well as immobilise the area if the symptoms are not improving. If all of these conservative methods tend not to help, there are also surgical choices that can help with the pain however may typically leave a little minor impairment, which can be a lot better in comparison to the persistent pain of an active sickness. The surgical treatment can be a decompression of the bone with drilling. Another option should there be areas of navicular bone destruction are a operative fusion of the joints around the damaged bone..

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