Mueller–Weiss disease

Description

Müller-Weiss disease (aka Brailsford disease) is a complex idiopathic foot condition with deformity of the tarsal navicular. Commonly presents in adulthood with chronic mid and hindfoot pain. Distinct from Köhler disease, the osteochondrosis of the tarsal navicular bone in children. 

Mueller–Weiss disease MWD 2
The flatfoot in Müller-Weiss disease (MWD) Source: Ahmed et al 2019

Definitions vary through the literature for MWS and MWD…

  • Müller-Weiss disease (MWD, Tarsal scaphoiditis): dysplasia of the tarsal navicular that is developed during childhood and suffered during adulthood. The talar head shifts laterally over the os calcis, driving the subtalar joint into varus
  • Müller-Weiss syndrome (MWS): spontaneous osteonecrosis of the tarsal navicular in adults, and a rare cause of chronic medial midfoot pain.

History of Mueller–Weiss disease

1925 – Georg Schmidt was the first to report a similar condition in a patient with pluriglandular insufficiency syndrome. No images provided.

1927Walther Müller (1888 – 1949), a German orthopedic surgeon published the first images of a compressed, condensed, and fragmented tarsal navicular. Müller described the “double navicular” as an osteological manifestation in a patient who developed a severe deformity of the navicular bone in both feet. In 1928, Müller attributed its aetiology as a congenital origin, not traumatic, being the compression the cause of this alteration

Ich hatte nun kurzlich Gelegenheit Veranderung am Os naviculare pedis beim Erwachsenen zu beobachten, die vielleicht gewisse ahnlichkeiten mit der Köhler-schen erkrankung der Jugendlichen aufweist, die aber in dieser form noch nicht bekannt ist.

Müller 1927

I have recently had occasion to observe changes in the os naviculare pedis in the adult, which may have some similarities with the Köhler-like disease of the adolescents, which is not yet known in this form.

Müller 1927

Müller 1927 Über eine eigenartige doppelseitige Veränderung des Os naviculare pedis beim Erwachsenen

1929Konrad Weiss (1891 – 1976) was an Austrian radiologist described two similar cases. Based on radiographic signs of increased bone sclerosis and adjacent joint space narrowing, Weiss postulated osteonecrosis as the underlying aetiology.

1939James F. Brailsford (1888 – 1961) further defined osteochondritis of the navicular bone or listhesis navicularis. He described 9 cases of osteochondritis of the tarsal navicular in adult women:

…an oblique splitting of the navicular and separation of the two fragments: the inner fragment gradually glides over the head of the astragalus to its medial side; the outer fragment overrides the dorsal surface of the second and third cuneiforms.

Brailsford 1939

Associated Persons

Alternative names
  • Müller – Weiss syndrome, Mueller – Weiss syndrome (MWS)
  • Mueller – Weiss disease, Müller – Weiss disease (MWD)
  • Listhesis navicularis

References

Original articles

  • Schmidt G. Köhler’sche Krankheit des Kahnbeins beider Füße in Verbindung mit pluriglandulärer Insuffizienz und als Ursache von Pes adducts. Münchener medizinische Wochenschrift. 1925; 72: 368-369
  • Müller W. Über eine eigenartige doppelseitige Veränderung des Os naviculare pedis beim Erwachsenen. Deutsche Zeitschrift für Chirurgie, 1927; 201: 84-87.
  • Müller W. Über eine typische Gestaltsveränderung beim Os naviculare pedis und ihre klinische Bedeutung. Fortschritte auf dem Gebiete der Röntgenstrahlen 1928; 37: 38–42.
  • Weiss K. Über die “Malazie” des Os naviculare pedis. Fortschritte auf dem Gebiete der Röntgenstrahlen, 1929; 40: 63-67.

Review articles


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Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

Resident medical officer in emergency medicine MB ChB (Uni. Dundee)  MRCS Ed. Avid traveller, yoga teacher, polylinguist with a passion for discovering cultures.

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