Navicular osteonecrosis

Case contributed by Dinesh Brand
Diagnosis almost certain

Presentation

History of fall and sprain injury.

Patient Data

Age: 30
Gender: Male
x-ray

No recent or healing bony injury is identified.

There is evidence of changes of Mueller Weiss syndrome - the navicular demonstrates patchy sclerosis (similar to avascular necrosis elsewhere).
 

Case Discussion

This is a classic case of osteonecrosis of the tarsal navicular bone also know as Mueller Weiss syndrome. This is typical of adult-onset with radiographic features of patchy sclerosis and thin dorsal protrusion.

Mueller Weiss syndrome can be progressive at times, and it is sometimes associated with severe pain and disability. The pediatric version is known as Köhler disease.

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