Kohler disease

Title

Other Names:

Kohler's Disease; Kohler's Disease of the Tarsal Navicular; Kohler's Osteochondrosis of the Tarsal Navicular; Kohler's Disease; Kohler's Disease of the Tarsal Navicular; Kohler's Osteochondrosis of the Tarsal Navicular; Navicular Osteochondrosis; Aseptic necrosis of the tarsal bone; Osteochondritis of tarsal/metatarsal bone; Osteochondrosis of the tarsal bone See More

Categories:

Musculoskeletal Diseases

Summary Summary

Kohler disease is a condition that affects a bone at the arch of the foot called the tarsal navicular bone. X-rays show that this bone is initially compressed and later breaks into pieces before healing and hardening back into bone. It occurs most frequently in children between the ages of 5 and 10 years. Signs and symptoms of the condition include swelling, redness and/or tenderness of the affected foot which can lead to a limp or abnormal gait (style of walking). Although the exact underlying cause of Kohler disease is unknown, some scientists suspect that it may be caused by excessive strain on the tarsal navicular bone and its associated blood vessels before the bone is completely ossified (hardened). The condition typically resolves on its own with or without treatment; however, pain relievers, rest, avoidance of weight-bearing activities, and/or casting may be recommended to help manage symptoms.^[1]^[2]

Last updated: 2/18/2014

Symptoms Symptoms

The signs and symptoms of Kohler disease vary, but may include:^[1]^[2]

Swelling of the foot
Redness of the affected area
Tenderness, particularly along the length of the arch
Limp or abnormal gait (style of walking)

Symptoms may worsen if weight is put on the affected foot, which can make walking painful and difficult.^[2]

Last updated: 2/18/2015

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms	Other Names	Learn More: HPO ID
80%-99% of people have these symptoms
Foot pain		0025238
30%-79% of people have these symptoms
Abnormal metatarsal ossification		0008371
Abnormality of the os naviculare pedis		0100339
Abnormality of the talus	Abnormal large bone of ankle	0008365
Ankle swelling		0001785
Chronic pain	Long-lasting pain	0012532
Difficulty walking	Difficulty in walking	0002355
Irregular tarsal ossification		0008134
Stiff skin		0030053
5%-29% of people have these symptoms
Abnormal tarsal bone mineral density		0009132
Abnormality of lower limb epiphysis morphology	Abnormal shape of end part of lower limb end bone	0006500

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Do you have more information about symptoms of this disease? We want to hear from you.

Last updated: 7/1/2019

Do you have updated information on this disease? We want to hear from you.

Cause Cause

The exact underlying cause of Kohler disease is unknown. However, some scientists suspect that it may be caused by excessive strain on a certain bone of the foot (tarsal navicular bone) and its associated blood vessels before the bone is completely ossified (hardened).^[1]

Bone ossification usually begins at age 18-24 months in girls and at age 24 to 30 months in boys. As the child grows, their foot is required to support more weight. Ossification of the tarsal navicular bone often occurs more slowly than the other bones of the foot. Consequently, surrounding bones may compress it and its blood vessels resulting in osteonecrosis and ischemia (a loss of blood supply).^[1]

Last updated: 2/18/2015

Inheritance Inheritance

The exact underlying cause of Kohler disease is currently unknown. Although some scientists have suggested that genetic factors may play a role in the development of Kohler disease, no disease-causing gene has been identified.^[1]

Last updated: 2/18/2015

Diagnosis Diagnosis

A diagnosis of Kohler disease is suspected based on the presence of characteristic signs and symptoms. An x-ray of the foot can be used to confirm the diagnosis and evaluate the progression of the condition.^[1]^[2]

Last updated: 2/18/2015

Treatment Treatment

Kohler disease typically resolves over time with or without treatment. However, pain relievers, rest and avoidance of weight-bearing activities can help alleviate some of the symptoms. In some cases, a plaster walking cast and/or arch supports may also be recommended.^[1]^[2]

Last updated: 2/18/2015

Prognosis Prognosis

The long-term outlook (prognosis) for people with Kohler disease is usually excellent. Symptoms can last from a few days to two years; however, most cases resolve within a year. People affected by the condition typically recover all function of the affected foot and have no lasting consequences.^[1]^[2]

Last updated: 2/18/2015

Learn More Learn More

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

The Merck Manuals Online Medical Library provides information on this condition for patients and caregivers.
The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

In-Depth Information

Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
PubMed is a searchable database of medical literature and lists journal articles that discuss Kohler disease. Click on the link to view a sample search on this topic.

GARD Answers GARD Answers

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know. Submit a new question

Is Kohler disease hereditary? See answer
How common is Kohler disease? I keep reading that it is rare but can't find stats on just how rare it is. See answer
What is Kohler disease? Also what's the difference between "osteochondrosis" and "osteonecrosis?" See answer

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