Kohler’s disease

What is Kohler’s disease

Kohler's disease affects the navicular bone in the foot. It happens when the bone temporarily loses its blood supply. This causes the bone to collapse and become flattened, causing pain and swelling of the foot. It affects people born male more than people born female and is typically seen in children between 4 and 7 years of age. Children typically experience pain on the top and inside surface of their foot. Kohler's disease gets better on its own with rest and medication for pain control. The healing process takes from 6 months to upwards of 3 to 4 years.

What are the signs and symptoms of Kohler's disease?

Kohler's disease occurs more commonly in people born male between 4 and 7 years old. Symptoms can include:

• limping or walking on the outer side of their foot
• tenderness
• swelling

How is Kohler's disease diagnosed?

A health-care provider will perform a physical exam of your child's foot. If Kohler's disease is suspected your child will also have an X-ray taken of their foot. If your child has Kohler's disease the X-ray will show fragmentation and flattening of the navicular bone.

How is Kohler's disease treated?

Treatment of Kohler's disease involves treating the symptoms and will include:

• taking weight off the affected foot
• stopping or modifying activities that cause pain
• wearing a walking boot that helps to support and protect the foot if it is very painful
• medications such as ibuprofen (e.g., Advil) or naproxen (e.g., Aleve)

Physiotherapy is rarely required as part of the treatment strategy.

The navicular bone can take between 6 months and 3 to 4 years to completely heal or for symptoms to disappear. Your child will have repeated X-rays every 3 to 6 months until the navicular bone can be seen to be getting thicker and healing.

At SickKids

SickKids does not accept referrals for Kohler's disease as it is a self-limiting condition and will get better on its own. No orthopaedic surgery consultation or treatment is required.

References

Lee, S. (2024, March 5). Köhler disease. Radiopaedia. https://radiopaedia.org/articles/k-hler-disease