Köhler Disease: Avascular Necrosis in the Child

Foot Ankle Clin. 2019 Mar;24(1):83-88. doi: 10.1016/j.fcl.2018.09.005. Epub 2018 Dec 10.


Köhler disease is a childhood condition of pain and swelling of the medial midfoot with associated osteochondrosis or avascular necrosis of the tarsal navicular. The age at presentation is between 2 and 10 years, with boys more likely to be affected than girls. Radiographs show increased sclerosis and sometimes flattening and fragmentation of the navicular. Long-term outcomes for Köhler disease are favorable regardless of the type of treatment, although a short period of immobilization with a short leg walking cast may reduce the duration of symptoms.

Keywords: Köhler disease; Midfoot pain; Navicular avascular necrosis; Pediatric patient.

Publication types

  • Review

MeSH terms

  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Foot Diseases / diagnosis*
  • Foot Diseases / therapy
  • Humans
  • Male
  • Osteonecrosis / diagnosis*
  • Osteonecrosis / etiology
  • Osteonecrosis / therapy
  • Tarsal Bones / pathology*