Brailsford Disease

Brailsford Disease is an alternative name that is occasionally used for Müller-Weiss Syndrome, an osteochrondritis of the tarsal navicular bone that occurs in adults causing midfoot pain.

What eventually became known as Müller-Weiss Syndrome was first described by Walther Müller in 1927 and by Konrad Weiss in 1927, both in the German literature. In the English literature, it was first described by the radiologist, James F. Brailsford in 1939. He also used the term,’listhesis navicularis’ to describe the osteochondritis of the tarsal navicular.

The characteristic lesion in the nine cases of osteochrondritis of the tarsal navicular in adult women have been described as 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. This breach between the two fragments reduces the distance between the proximal articular surfaces of the second and third cuneiforms, on the one hand, and the head of the astragalus, on the other, and ultimately these cuneiform surfaces may even articulate with the head of the astragalus. In the later stages, severe osteoarthritic changes develop in the abnormal mid-tarsal joint.

The ages of the affected patients were as follows: tw^enty-two, thirty-turn, forty-five, fifty-one, fifty-two, fifty-two, fifty-six, fifty-seven, and fifty-nine. In the two younger patients, no secondary arthritic changes could be detected in the affected bones, but in all the others, with the exception of Case 3, marked osteo-arthritic changes were evident. The roentgenograms of Case 3, when the patient was fifty-two years of age, showed almost complete medial dislocation of the inner fragment of the navicular, but no secondary arthritic changes were detectable. Six years later, severe arthritic changes were observed. This suggests that the displacement had occurred within a year or so of the first roentgeno- graphic examination.

In three patients— Cases 2, 3, and 4 — the first metatarsal was short, the second metatarsal was hypertrophied, and the third, fourth, and fifth metatarsals were atrophied. The other cases did not demonstrate these features, although in Cases 5 and 7 some atrophy of the metatarsals was suggested.

No cases presenting similar roentgenographic appearances were observed in men.

Brailsford, JF: Osteochondritis of the adult tarsal navicular. The Journal of Bone and Joint Surgery; Vol 21(1)111-120 January 1939. (full text)

James F. Brailsford (1888 – 1961) was a Sergeant Radiographer in the British army during WW1 and after the war’s end in 1918 he attended the Birmingham Medical School in Birmingham, England at the age of 30. He then held radiological education posts at the University of Birmingham. In 1934 he was responsible for founding the British Association of Radiologists and was its first president. He was the author of the book, The Radiology of Bones and Joints (1934).

As well as his description in 1939 of what became Brailsford Disease, he is also known for his descriptions of a rare form of skeletal dysplasia in 1929 (Morquio-Brailsford syndrome).

Related Pages:
Mueller-Weiss syndrome and Rafael Nadal

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