Kohlers disease
Moderator(s): Michael Harvey
Page 1 of 1
Forum Actions

Topics   Replies Score Author Latest Post
Kohler's disease 0 M. Harvey Köhler disease (navicular osteochondrosis) We have had a couple a couple kids present with foot pain and unusual foot x-rays to our Ortho Urgent Care over the last few months. These kids were diagnosed with Kohler Disease. I had no idea what this was until a couple of other PAs on our team did some quick research and spoke to two of our pediatric ortho surgeons. Here is the quick synapse. ·         Occurs in children younger than 10. ·         Usually idiopathic but may be prompted by remote trauma. ·         Patient presents with progressive midfoot pain with weight bearing. ·         More common in boys (80%). ·         Can be bilateral in 25% of the cases. ·         They have decrease blood flow to the central 1/3 of the navicular causing avn. ·         The navicular is the last bone in the foot to ossify. ·         Also puts them at increased risk of stress fx of navicular ·         Often misdiagnosed as an infection. ·         Xrays show sclerosis, fragmentation, and flattening of navicular   Prognosis: says most of the tarsal navicular bones reorganize after disease has ran its course usually 6-48 months. Tx: NSAIDS, immobilize with boot or short leg walking cast. Modify activities. In follow-up may consider prescription arch support to offload pressure Just another unusually pediatric condition that those of us who don’t specialize in pediatrics should keep on your radar.
by M. Harvey
Thursday, November 1, 2018