DOI: https://doi.org/10.36347/sasjm.2026.v12i08.003

Pages: 786-790

Müller-Weiss disease is a rare disorder of the tarsal navicular in adults, traditionally considered to be aseptic osteonecrosis, although its pathophysiology remains controversial. We report the case of a 56-year-old man with no significant medical history who had experienced mechanical dorsomedial pain in the right midfoot for three months, without any triggering trauma. The pain, rated 7/10 on the visual analog scale, was associated with an antalgic gait and a walking distance limited to approximately 500 meters. Examination revealed collapse of the medial longitudinal arch, dorsomedial prominence of the navicular, and painful limitation of midfoot and subtalar joint mobility. Weight-bearing radiographs of the feet showed compression of the lateral portion of the right navicular, osteosclerosis, and a characteristic comma-shaped deformity without fragmentation. MRI demonstrated a flattened and deformed navicular, with low T1 signal and high T2-STIR signal, without fracture or associated perinavicular involvement. The etiological workup identified no secondary cause. A diagnosis of idiopathic Müller-Weiss disease was retained. Conservative treatment combined offloading, celecoxib for two weeks, followed by progressive resumption of weight-bearing with a plantar orthosis. The outcome was favorable, with pain reduction from the third week and satisfactory functional recovery at three months. This case is distinguished by its occurrence in a man, its early diagnosis, the absence of classic risk factors, and the short-term success of conservative treatment.