Köhler Disease (Aseptic Necrosis of the Tarsal Navicular), Sports Medicine

Kevin E. Burroughs, MD, CAQSM Reviewed 04/2019

BASICS

DESCRIPTION

Pediatric osteochondrosis of the tarsal navicular, first described by Alban Köhler in 1908 1
Osteochondrosis is a disease process that causes necrosis of the ossification center of a ...

DIAGNOSIS

Although variations in morphology of the navicular have been described, the diagnosis of Köhler disease is made on the basis of both clinical and radiographic findings.

HISTORY

It is often di...

TREATMENT

GENERAL MEASURES

Acute treatment:
- Apply ice to midfoot.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen can be used for analgesic effect.
- Immobilization to affect relief of sympto...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Orthopedic referral is indicated if symptoms do not resolve with conservative management.

Patient Monitoring

In a study of 12 cases, complete restoration of normal...

REFERENCES

Köhler A. A frequent disease of individual bones in children. Munch Med Wochenschr. 1908;55:1923–1925.

Santos L, Estanqueiro P, Matos G, et al. Köhler disease: an infrequent or under...

ADDITIONAL READING

Borges JL, Guille JT, Bowen JR. Köhler’s bone disease of the tarsal navicular. J Pediatr Orthop. 1995;15(5):596–598.
Gips S, Ruchman RB, Groshar D. Bone imaging in Kohler’s dis...

CLINICAL PEARLS

Although all patients eventually will have complete resolution of symptoms, immobilization with a cast for at least 8 wk shortens the duration of symptoms by ~1 yr.
Sports may be resume...

Subscribe to Access Full Content

START 10-DAY FREE TRIAL

Subscribe Now

Forgot password?

Enter an Access Code

GET CME/CE