Mueller Weiss syndrome

Case contributed by Dr Mohamed Saber


A long history of mid-foot pain.

Patient Data

Age: 65 years
Gender: Female

MRI study shows the following:

  • abnormal morphology of the navicular bone giving a “comma-shaped” deformity on top of partial collapse of the lateral part of the bone . It also shows abnormal bone marrow signal eliciting high signal on STIR / PDFS with small cystic changes.
  • evidence of midfoot inter-tarsal osteoarthritic changes in the term of narrowing of the joint spaces, marginal osteophytes, and patchy bone marrow edema.
  • soft tissue edema of the foot more at the dorsal aspect.

Case Discussion

Mueller Weiss syndrome refers to spontaneous multifactorial adult-onset osteonecrosis of the tarsal navicular. It is distinct from Köhler disease, the osteonecrosis of the tarsal navicular bone that occurs in children.

In this case, the patient was a female in her sixties and complaining of a long history of mid-foot pain. On MRI, the navicular bone presents a “comma-shaped” deformity. Both clinical and MRI criteria are highly suggestive of  Mueller Weiss syndrome.

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