Presentation
Mid and hindfoot pain and deformity.
Patient Data
Signal alteration and collapse of lateral half of navicular bone along with dorsolateral extrusion of fragmented segments and mild medial subluxation of navicular tuberosity. In response to exaggerated stress, hypertrophy of talar ridge, located between the distal articular surface of talus and trochlea ,leading to wide talar head appearance as well as a large osteophyte overlying the distal aspect of the talus.
Further injuries:
• Subtalar hindfoot varus and severe perinavicular joint degenerative changes as well as evidence of medial impingement in medial aspect of talus and calcaneous
• An unstable osteochondral lesion in medial aspect of talar dome
• Complete tear of anterior talofibular ligament, sprain and partial interstitial tear of posterior talofibular and posterior inferior tibiofibular as well as deltoid ligaments
• Interstitial edema of Flexor hallucis longus and low-lying soleus muscles
• Tendinosis of Achilles, peroneal and posterior tibialis tendons
• Evidence of plantar fasciitis, sinus tarsi syndrome and sprain of ligaments of Chopart’s joint.
Case Discussion
Mueller-Weiss syndrome is a multi factorial disease which is more common in women and usually affects adults between the age of 40 and 60 years and is frequently bilateral. It is probably related to chronic loading on a suboptimally ossified navicular bone which is predisposed to central ischemia.