Mueller-Weiss disease of the navicular bone

Mueller Weiss disease is a rare source of pain within the midfoot in adults that has been also known as Brailsford disease. It is a sudden onset osteonecrosis of the navicular bone in the foot. You will find there’s a a lot more well-known problem of the same bone in young childen known as Köhler disease, which is also an osteonecrosis in the tarsal navicular bone, but they are completely different conditions due to the nature with the developing bone tissues in youngsters. The condition was first described by Schmidt in1925. It was W Muller who afterwards proposed how the underlying mechanism of the disorder has been due to an excessive compression force upon the midfoot region. About the same period, K Weiss, noted which the appearances on x-ray were similar to those noticed in a condition known as Kienbock disease, and this is an osteonecrosis. The two of these reviews led to the most commonly used name for this problem, Mueller Weiss syndrome.

Mueller Weiss disease usually affects adults in between forty and sixty years of age (Köhler disease has a common starting point around 5 years of age). It is more prevalent in females. It might have an impact on just one foot, or it can affect both feet. The common symptoms include the gradual oncoming of pain in the mid-foot and hindfoot that may often be localized to the most agonizing area being over the navicular. A flat foot is in addition more common in those with this issue. The easiest way to diagnose Mueller Weiss disorder is via the use of radiology. On x-ray there will probably appear to be a failure of areas of the bone and sclerosis along with comma-shaped deformity on the lateral aspect. A CAT scan may also display similar issues and could be helpful to appraise the stage with the problem in far more detail. A magnetic resonance image can be more sensitive to aid in the diagnosis since it is capable of detect changes in the bone marrow.

Mueller Weiss disease is often progressive and may produce severe pain and become fairly disabling, so treatment should be commenced as early as possible to prevent it from becoming impaired too much. Initial treatment methods are to limit activities, perhaps some pain alleviation medicines and use supportive footwear. Usually foot orthotics are used to help further stabilise the area and support the mid-foot (arch) of the feet. This will keep a lot of stress from the navicular. If that is not really helping, then a even more limitation in weight bearing amounts is essential which means that there is much less pressure around the painful navicular. A moon boot or walking splint is the next phase to help protect and also immobilise the area if the signs and symptoms aren’t improving. If most of these conservative approaches do not help, there are also surgical options that can help with the soreness but can frequently result in some minimal disability, which can be a lot better in comparison to the continual pain of an active disease. The particular surgical treatment might be a decompression of the bone tissue using drilling. Another option in case there are regions of bone destruction would be a operative fusion of the important joints around the bone.

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