What is it?

Kohler's disease is a condition, where the navicular bone in the foot undergoes avascular necrosis. For some unknown reason, typically in a child, the navicular bone in the foot loses its blood supply for a while.

What are the symptoms?

The typical patient is a boy, although it can sometimes happen to a girl. The boy is usually around 5 years old, who complains of pain in the foot over the apex of the longitudinal arch. He walks with a limp, and tends to walk on the outer body of his foot.

What does your doctor do about it?

Your doctor will order X-rays of both feet to compare them. The affected foot usually has typical findings of a dense flattened navicular bone, compared to the normal foot. Treatment may consist of a walking cast if the pain is severe, or an UCB arch support if the pain is less so. Non-steroidal anti-inflammatory medications may help. The child may have to rest from sports for a few weeks till the acute pain is relieved.

What of the future?

Most patients respond well to treatment. Follow-up X-rays in one year usually show that the navicular bone circulation and structure is restored, and the patient is totally asymptomatic. There are no long term problems consequent to this disease.