Köhler disease

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

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

Although the etiology 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.

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

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

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. 

It was first described in 1908 by Alban Köhler, a German radiologist (1874-1947) 1,6

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

Article information

rID: 9386
Synonyms or Alternate Spellings:
  • Köhler's disease
  • Kohler disease
  • Kohler's disease

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  •  Case 1
    Drag here to reorder.
  • Case 2
    Drag here to reorder.
  •  Case 3
    Drag here to reorder.
  • Case 4
    Drag here to reorder.
  • Case 5
    Drag here to reorder.
  • Case 6
    Drag here to reorder.
  • Case 7
    Drag here to reorder.
  • Case 8
    Drag here to reorder.
  • Case 9
    Drag here to reorder.
  • Case 10
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.