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Mueller Weiss syndrome

Case contributed by Teun W. F. Pappot
Diagnosis almost certain

Presentation

Long term history of left forefoot pain not related to trauma.

Patient Data

Age: 70 years
Gender: Female

Left foot

x-ray

There is sclerosis and collapse of the lateral aspect of the navicular. There is degenerative change within the lateral cuneonavicular joint.

Left foot

mri

There is a collapse of the lateral aspect of the navicular with fragmentation, result in the typical comma-shaped deformity. There is associated degenerative change within the lateral cuneonavicular joint with full-thickness cartilage loss and subchondral sclerosis.  

A moderate amount of bone marrow edema signal is present within the mid and lateral navicular and lateral cuneiform. 

Case Discussion

Spontaneous osteonecrosis of the lateral navicular is also known as Mueller Weiss syndrome. The typical appearance is a collapse of the lateral aspect of the navicular, resulting in a comma-shaped deformity. The development of early osteoarthritis is common.

Although the precise etiology remains subject of debate, the combination of relatively poor blood supply of the navicular and localized mechanical strain are contributing factors for the development of osteonecrosis. 

Women are more affected than men with a mean age of 47 years. 

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