Clinical Features

A relatively rare condition, Müller-Weiss diseaseMüller-Weiss disease is being increasingly recognized worldwide through greater awareness. Frequently bilateral, it affects females predominantly. It has been reported in all 5 continents. The first biggest study came from Spain. With a noticeable dearth of literature from the Americas, large series have recently emerged from Northern Ireland, Thailand and China. Sometimes discovered as an incidental finding, many patients often give a long-standing history of spontaneous onset of symptoms before seeking medical attention. Degree of deformity does not correlate with severity of symptoms. When evaluating peekaboo signPeekaboo sign for subtle hindfoot varus, it is important to view the heels at ankle level and not from an elevated height at knee level. Palpate each perinavicular jointPerinavicular joints for tenderness in preparation for selection of which joints to fuse if arthrodesis surgery is required. Depending on stage of the disease, the medial arch may be elevated, normal or flattened. Heel varusHeel varus is not always the rule. When the arch is flat and the heel is in varus, the term ‘paradoxical pes planus varusParadoxical pes planus varus’ may then be correctly applied. In the differential diagnosis of Müller-Weiss diseaseMüller-Weiss disease, Köhler’s disease and navicularNavicular stress fractures demonstrate different clinical and radiographic characteristics.