What is Mueller Weiss syndrome in the foot?
The Mueller Weiss disorder is a rare cause of pain within the midfoot in adults which was also called Brailsford disease. It is a spontaneous onset osteonecrosis of the tarsal navicular in the foot. You will find there's a a lot more well-known problem of the same bone in children known as Köhler disease, which is also an osteonecrosis with the tarsal navicular bone, however they are distinctive disorders because of the character of the developing bone tissues in children. The condition was first described by Schmidt back in 1925. It had been W Muller whom afterwards recommended that the pathophysiology with the condition was as a result of an unnatural compression force on the mid-foot region. About the same period, K Weiss, reported which the look on radiographs were much like those seen in a disorder known as Kienbock disease, which is also an osteonecrosis. These two accounts resulted in the most frequently used term for this disease, Mueller Weiss syndrome.
Mueller Weiss syndrome frequently occurs in adults between 40 and sixty years of age (Köhler disease has a typical onset around five years of age). It is more prevalent in females. It might have an impact on only one foot, or it can affect both feet. The common signs and symptoms include the slow oncoming of discomfort in the midfoot and hindfoot which may often be localised to the most agonizing area being about the navicular. A flat foot is in addition more common in individuals with this condition. The best method to diagnose Mueller Weiss disorder is via using radiology. On a x-ray there will probably appear to be a collapse of portions of the navicular and a whiteness with comma-shaped deformity with the outside part. A CAT scan also can demonstrate similar irregularities and can be used to evaluate the stage of the problem in a lot more detail. A MRI is often more sensitive to aid in the verification because it is capable of detect changes in the bone marrow.
Mueller Weiss syndrome is generally progressive and might result in significant pain and be rather disabling, so treatment needs to be started as early as possible to prevent the navicular from becoming damaged too much. Primary treatment is to reduce weight bearing, possibly some pain alleviation drugs and use supporting footwear. Quite often foot orthotics are widely used to help further stabilise the bones and support the mid-foot (arch) of the foot. This will keep a lot of force off the navicular bone. If that's not really making a difference, then a more reduction in weightbearing amounts is necessary which means that there is significantly less force on the painful area. A moon boot or walking brace will be the next phase to further protect and immobilise the area if your signs and symptoms aren't improving. If these types of conservative techniques usually do not help, you can also find surgical choices that can help with the soreness however do frequently result in a little minor impairment, that is more desirable compared to the chronic pain of an active condition. The surgical treatment may be a decompression of the navicular bone using drilling. Another option should there be areas of navicular bone deterioration would be a surgical fusion of the joints around the damaged bone..