Köhler’s disease is a rare, self-limiting condition that primarily affects children, usually between the ages of 3 and 7, and more often boys than girls. It involves the avascular necrosis of the navicular bone in the foot, meaning that blood supply to this bone is temporarily disrupted, causing bone tissue to die. The exact cause isn’t fully understood, but it’s thought to be related to mechanical stress on a developing navicular bone that has not yet fully ossified. Kids may experience pain, swelling, and tenderness on the medial side of the foot, often leading to a limp or a refusal to walk. Radiographs typically show a sclerotic and flattened navicular bone, which is key for diagnosis.
Despite sounding serious, Köhler’s disease usually has a good prognosis. Symptoms often resolve on their own within 6 months to 2 years as the blood supply returns and the bone heals. Treatment mainly focuses on relieving discomfort — this could include rest, limiting weight-bearing activities, arch supports, or in more symptomatic cases, a short leg cast for a few weeks. Long-term complications are rare, and most kids regain full function without deformity. It’s crucial, though, to differentiate Köhler’s disease from other causes of foot pain in children, like infections or tarsal coalition, to avoid unnecessary interventions..
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