Navicular avascular necrosis (Köhler disease)

Case contributed by Dr Benoudina Samir

Presentation

History of intermittent limping left foot pain with inability to bear weight. No history of trauma, fever or systemic illness.

Patient Data

Age: 4
Gender: Male
Modality: X-ray

Irregular sclerosis of the navicular bone ossification center. The appearance is compatible with avascular necrosis of the navicular (Kohler's disease).

Case Discussion

There is a long list of possible diagnoses for a limping child. Köhler disease is an unusual one. For this child, clinical examination of the hip, knee and foot was unremarkable. Full blood count and C reactive protein were also normal. Radiographs of pelvis and knee were negative. Finally, it is the foot radiograph that helped to explain this inability to bear weight.

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Case Information

rID: 51545
Case created: 24th Feb 2017
Last edited: 25th Feb 2017
System: Paediatrics
Inclusion in quiz mode: Included

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