Introduction Adult-onset spontaneous osteonecrosis of the navicular bone is a rare disorder known as Mueller-Weiss syndrome. Patients with this disorder present with a painful clinical course and progressive deformity. Koehler's disease, spontaneous osteochondrosis of the navicular bone in children, is a separate entity, and should not be confused with Mueller-Weiss syndrome. These disorders differ not only in age at onset but also in clinical outcome and radiological findings. Mueller first described osteonecrosis of the navicular bone in adults and summarized his radiological findings as medial and/or dorsal protrusion of the navicular bone associated with collapse of the lateral aspect of the bone. Current literature suggests both early and late radiological changes. Initially there is loss of volume and increased radiodensity observed in the lateral aspect of the navicular bone. This is followed by a comma-shaped navicular bone and dorsal protrusion and fragmentation. Fracture lines may also be visualized on CT, and a homogeneous decrease in signal intensity of the navicular bone can be seen on T1-weighted MR images.
Discussion Here we present an interesting case of adult-onset avascular necrosis of the navicular bone. The patient's initial presentation, diagnostic work-up, and radiological findings will be discussed.
Conclusion Mueller-Weiss syndrome is a difficult diagnosis to make. However, diagnosis can be aided by radiological images especially with CT and MR guidance. We present this case in the hope of increasing awareness of this disease and to demonstrate some of the common radiological findings that can be used to aid diagnosis.
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