Kohler Disease

Kohler disease was first described by Alban Kohler in 1908 and referred to avascular necrosis of the navicular bone of the foot. Kohler disease is a disease only seen in pediatric patients. Although the etiology is not fully understood, it is thought to be caused by the compression of the navicular bone prior to ossification. This leads to blood flow abnormalities resulting in avascular necrosis. Kohler disease is most commonly seen in males ages 4 to 7 years old. Kohler disease is typically unilateral, although one report in the literature found that 25% of Kohler disease is bilateral. Patients typically present with medial-sided foot pain, swelling of the medial foot, and/or a limp. On plain films, the navicular will have standard characteristics of avascular necrosis (AVN), including sclerosis, fragmentation, and flattening. Kohler disease is a self-limiting condition with an excellent prognosis. There have been no reported cases of Kohler disease developing long-term clinical or radiologic abnormalities.