Köhler disease

Köhler disease is an eponymous term referring to childhood-onset osteonecrosis of the navicular bone in the foot. Mueller Weiss syndrome is the adult counterpart of navicular bone osteonecrosis .


It typically presents in the pediatric population (4-6 years of age) and there is a recognized male predilection.


Although the etiology remains unknown, a vascular incident is suspected. Delayed bone age has also been noted in some cases and may play a part in the pathogenesis of this entity.

Radiographic features

Plain radiograph
  • navicular may appear wafer-like (thinned) and fragmented
  • demonstrates patchy sclerosis (similar to osteonecrosis elsewhere)
  • often associated soft tissue swelling

Cross-sectional imaging is usually not required but may be necessary if pain persists or the diagnosis is not clear.

Treatment and prognosis

Köhler disease often tends to be self-limiting and heals spontaneously with reossification and reconstitution within a few years. Application of a below-knee weight-bearing cast may improve symptoms and is recommended, typically for 6-to-7 weeks.

History and etymology

It was first described in 1908 by Alban Köhler, a German radiologist (1874-1947) .

Differential diagnosis

Usually, there is little difficulty in making the diagnosis. If symptoms persist then tarsal coalition should be sought.

See also

Siehe auch:
und weiter: