Dr. Ebraheim’s educational animated video describes the condition of Kohler's disease.

Kohler’s disease is avascular necrosis of the navicular bone in the foot. It could be misdiagnosed as infection. Prognosis is usually good. The central third of the navicular bone has the worst blood supply. Suboptimal blood supply to the navicular bone may lead to avascular necrosis and stress fractures. As the child increases in weight, the unossified navicular bone is quite susceptible to become squashed between the talus and the cuneiform bones. This condition is very similar to Kienbock’s disease of the lunate bone in the wrist.
Presentation
Kohler’s disease is more commonly seen in boys. It can be bilateral. The patient may be asymptomatic or complain of midfoot pain in the dorsomedial aspect of the foot. Pain may be related to physical activities. The patient may also be limping or noticed to be walking on the lateral side of the foot due to pain.
Examination
There could be swelling, tenderness, warmth, or redness at the area of the navicular bone. Rule out infection.
Radiology
xrays may show sclerosis and/or fragmentation of the navicular.
Prognosis
This is a selflimiting condition. Even if the bone is deformed, the patient can remain asymptomatic.
Treatment
Treatment usually consists of a short leg walking cast. Surgery is usually not indicated.



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Background music provided as a free download from YouTube Audio Library.
Song Title: Every Step