What is Kohler Disease?
Kohler disease is a rare bone disorder in children characterized by pain and swelling along the arch of one or both feet. It is commonly seen between the ages of 5 and 7, with boys 4-5 times more likely to be affected. It is usually a self-limiting condition.
Causes of Kohler Disease
The exact cause of Kohler disease is not known; however, it may be due to an injury to the navicular bone in the midfoot or the nearby blood vessels before complete development of the bone (ossification). This leads to temporarily impaired blood supply and tissue damage. The bone development in the region occurs more slowly than normal as a result of the injury.
Symptoms of Kohler Disease
Based on the severity of the condition, the symptoms may last for weeks to up to 2 years and include:
- Swollen foot
- Foot pain
- Redness near the navicular bone (inner aspect of the midfoot)
- Bearing weight on the outer aspect of the foot due to the pain
- Tenderness near the navicular bone
Diagnosis of Kohler Disease
A diagnosis of Kohler disease is made based on the following:
- Physical examination: This includes palpation to detect any tenderness near the navicular bone.
- X-rays: This test identifies a flattened, sclerotic, and fragmented navicular bone.
Treatment for Kohler Disease
Kohler disease usually resolves within 18 to 24 months. Symptoms can be managed by avoiding activities that aggravate the condition and taking medications to reduce pain. If the pain is intense, a plaster walking cast will be provided. Insoles may be suggested after the removal of the walking cast to support the arch of the foot. Special shoes can also be recommended for a faster recovery.