Kohlers Disease

Summary

  • Kohler’s disease is a relatively uncommon condition of avascular necrosis of the navicular which leads to pain and swelling in a child’s foot.
  • Sickle cell anemia is a risk factor.

Diagnostic tips

  1. Occurs in children between the ages of 4 and 9.
  2. Common in boys.
  3. Pain and swelling in the midfoot particularly at the navicular
  4. Movement of the mid and hindfoot may create discomfort
  5. Limping.

Tests and Imaging

  1. Xray will confirm avascular necrosis.

Immediate Treatment

  1. Minimize weight-bearing activities until the condition settles.
  2. Short-leg walking cast or cam walker for up to six weeks followed by comfort shoes and supportive orthoses to allow the bone to settle and the symptoms to improve.

Possible Referral

  1. Podiatry for footwear advice, cam walker, orthoses to limit loading of the area
  2. Surgery is not indicated for this disease.

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