Is a Rare Bone Disease

Kohler’s disease is a rare condition in which the tarsal navicular bone (a bone in the arch of the foot) becomes inflamed.

This bone disease is named after the German radiologist who described the condition in the early twentieth century. Kohler’s disease usually affects children between the ages of three and five. It occurs more commonly in boys than in girls, and is often unilateral, affecting one foot. It is described as an avascular necrosis, or osteonecrosis, in which bone tissue deteriorates due to an interruption of blood supply. Bone affected by avascular necrosis can break into tiny fragments before healing and hardening.  As a result, the foot becomes swollen and painful, and the arch of the foot is tender.

Cause of Kohler’s Disease

What causes avascular necrosis of the navicular bone is unclear, but a delayed ossification, or hardening of bone, may be partially responsible. Skeletal growth and maturation in children is a process that takes place over time, up until about 15 to 17 years of age. In a child who is developing normally, the navicular bone is the last tarsal bone to ossify (harden). As the child gains weight, there is more pressure on the bones of the foot, and a not fully ossified navicular bone can become compressed between adjacent bones, namely the talus and cuneiforms. Compression of the navicular bone’s blood vessels may result in the avascular necrosis of Kohler’s disease.

Source: footvitals

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