Köhler disease

Changed by Frank Gaillard, 18 Feb 2018

Updates to Article Attributes

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Köhler disease is an eponymous term referring to chilhood onsetchildhood-onset osteonecrosis of the navicular bone in the foot. Mueller Weiss syndrome is the adult counterpart of navicular bone ostoenecrosisosteonecrosis 4,5 .

Epidemiology

It typically presents in the paediatric population (4-6 years of age) and there is a recognised male predilection.

Pathology

Although the aetiology remains unknown, a vascular incident is suspected. Delayed bone age has also been noted in some cases and may play a part in the pathogenesis of this entity.

Radiographic features

Plain radiograph
  • navicular may appear wafer-like (thinned) and fragmented
  • demonstrates patchy sclerosis (similar to osteonecrosis elsewhere)
  • often associated soft tissue swelling
CT/MRI

Cross-sectional imaging is usually not required but may be necessary if pain persists or the diagnosis is not clear. 

Treatment and prognosis

Köhler disease often tends to be self-limiting and heals spontaneously with reossification and reconstitution within a few years. Application of a below-knee weight-bearing cast may improve symptoms and is recommended, typically for 6-to-7 weeks. 

History and etymology

It was first described in 1908 by Alban Köhler, a German radiologist (1874-1947) 1

Differential diagnosis

Usually, there is little difficulty in making the diagnosis. If symptoms persist then tarsal coalition should be sought.

See also

  • -<p><strong>K<strong>öhler disease</strong></strong> is an eponymous term referring to chilhood onset <a href="/articles/osteonecrosis">osteonecrosis</a> of the navicular bone in the foot. <a href="/articles/mueller-weiss-syndrome">Mueller Weiss syndrome</a> is the adult counterpart of navicular bone ostoenecrosis <sup>4,5</sup> .</p><h4>Epidemiology</h4><p>It typically presents in the paediatric population (4-6 years of age) and there is a recognised male predilection.</p><h4>Pathology</h4><p>Although the aetiology remains unknown, a vascular incident is suspected. Delayed bone age has also been noted in some cases and may play a part in the pathogenesis of this entity.</p><h4>Radiographic features</h4><h5>Plain radiograph</h5><ul>
  • +<p><strong>K<strong>öhler disease</strong></strong> is an eponymous term referring to childhood-onset <a href="/articles/osteonecrosis">osteonecrosis</a> of the navicular bone in the foot. <a href="/articles/mueller-weiss-syndrome">Mueller Weiss syndrome</a> is the adult counterpart of navicular bone osteonecrosis <sup>4,5</sup> .</p><h4>Epidemiology</h4><p>It typically presents in the paediatric population (4-6 years of age) and there is a recognised male predilection.</p><h4>Pathology</h4><p>Although the aetiology remains unknown, a vascular incident is suspected. Delayed bone age has also been noted in some cases and may play a part in the pathogenesis of this entity.</p><h4>Radiographic features</h4><h5>Plain radiograph</h5><ul>

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