Mueller Weiss disease is a rare reason for pain within the midfoot in adults which was also known as Brailsford disease. Mueller Weiss Syndrome is a spontaneous onset osteonecrosis of the tarsal navicular within the foot. There is a much more well-known problem of the same bone in children known as Köhler disease, which is also an osteonecrosis in the tarsal navicular bone, but they are distinctive disorders as a result of the characteristics with the growing bone tissues in youngsters. The problem was initially documented by Schmidt back in 1925. It had been W Muller who later on suggested that the pathophysiology with the problem has been due to an excessive compressive force on the midfoot area. Around the same time, K Weiss, reported how the look on x-ray were a lot like those found in a condition referred to as Kienbock disease, and this is an osteonecrosis. Both of these publications led to the most commonly used term for this disease, Mueller Weiss syndrome.
Mueller Weiss disorder typically occurs in adults between 40 and sixty years of age (Köhler disease has a typical starting point around five years of age). It appears to be more common in females. It may affect only one foot, or it could have an impact on both feet. The traditional symptoms include the slow oncoming of pain in the mid-foot and hindfoot that can often be localised to the most painful spot being around the navicular. A flat foot is also more prevalent in those that have this problem. The gold standard to diagnose Mueller Weiss syndrome is via the use of radiology. On x-ray there will seem like a collapse of portions of the bone and a whiteness and a comma-shaped deformity in the outside part. A CAT scan also can demonstrate similar abnormalities and can be used to look at the stage with the condition in additional depth. A magnetic resonance image can be more sensitive to help with the diagnosis as it is capable of identify variations in the bone tissues.
Mueller Weiss disorder is typically progressive and can produce severe pain and become quite debilitating, so treatment ought to be commenced as early as possible to prevent the bone from becoming impaired too much. Initial treatment methods are to reduce activities, perhaps some pain alleviation medications and use supportive footwear. Usually foot orthotics are widely-used to help further stabilise the bones and support the arch of the feet. This keeps a lot of pressure off the navicular. If that is not necessarily making a difference, after that even more limitation in weight bearing levels is required which means that there is much less strain on the painful navicular. A moon boot or walking splint is the next step to help protect and immobilise the region if the symptoms may not be getting better. If all of these conservative techniques tend not to help, there are also operative choices that will help with the soreness however may often result in a little modest impairment, which is more desirable when compared to the continual soreness of an active sickness. The particular surgical treatment might be a decompression of the navicular bone with drilling. Another option should there be areas of bone tissue deterioration can be a operative fusion of the important joints round the navicular.