*Rheumatology Department, Mohamed Kassab Institute of Orthopedics, La Manouba, Tunisia.
†University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia.
J Am Podiatr Med Assoc. 2023 Jan-Feb;113(1). doi: 10.7547/21-070.
Mueller-Weiss disease, a rare and complex foot condition, is defined as spontaneous and progressive navicular fragmentation leading to midfoot pain and deformity. However, its exact etiopathogenesis remains unclear. We report a case series of tarsal navicular osteonecrosis to describe the clinical and imaging characteristics and etiologic profile of the disease.
This retrospective study included five women diagnosed as having tarsal navicular osteonecrosis. The following data were extracted from medical records: age, comorbidities, alcohol and tobacco consumption, history of trauma, clinical presentation, imaging modalities performed, treatment protocol, and outcomes.
Five women with a mean age of 51.4 years (range, 39-68 years) were enrolled in the study. Mechanical pain and deformity over the dorsum of the midfoot was the main clinical presentation. Rheumatoid arthritis, granulomatosis with polyangiitis, and spondyloarthritis were reported by three patients. Radiographs revealed bilateral distribution in one patient. Three patients underwent computed tomography. It showed a fragmentation of the navicular bone in two cases.Magnetic resonance imaging was performed in one patient showing flattening of the lateral aspect of the navicular bone with signal abnormalities. Talonaviculocuneiform arthrodesis was performed in all of the patients.
Mueller-Weiss disease-like changes may occur in patients with an underlying inflammatory disease such as rheumatoid arthritis and spondyloarthritis.
Mueller-Weiss 病是一种罕见且复杂的足部疾病，其特征为自发性和进行性舟状骨碎裂，导致中足疼痛和畸形。然而，其确切的病因仍然不清楚。我们报告了一系列跗骨舟状骨骨坏死病例，以描述该疾病的临床和影像学特征及病因特征。
这项回顾性研究纳入了 5 名被诊断为跗骨舟状骨骨坏死的女性患者。从病历中提取以下数据：年龄、合并症、酒精和烟草使用情况、创伤史、临床表现、影像学检查、治疗方案和结果。
研究纳入了 5 名平均年龄为 51.4 岁（范围为 39-68 岁）的女性患者。主要的临床表现为中足背侧的机械性疼痛和畸形。3 名患者报告有类风湿关节炎、肉芽肿性多血管炎和脊柱关节炎。1 名患者的放射照片显示双侧分布。3 名患者进行了计算机断层扫描，其中 2 例显示了舟状骨骨碎裂。1 名患者进行了磁共振成像，显示舟状骨外侧表面变平并伴有信号异常。所有患者均进行了距舟楔关节融合术。
Mueller-Weiss 病样改变可能发生在患有类风湿关节炎和脊柱关节炎等潜在炎症性疾病的患者中。
