Köhler bone disease is osteochondrosis of the tarsal navicular bone, usually affecting children between the ages of 3 and 5. Symptoms include unilateral pain and swelling in the feet and a limping gait. Radiography may identify unilateral tarsal navicular flattening. The disease is self-limiting, but analgesics and plaster casts may alleviate symptoms in the short term.
Köhler bone disease is a rare, idiopathic, unilateral osteochondrosis of the tarsal navicular bone. It usually affects children aged 3 to 5 years (more commonly boys).
In Köhler bone disease, the foot becomes swollen and painful; tenderness is maximal over the medial longitudinal arch. Weight bearing and walking increase discomfort, and gait is disturbed.
On radiographs, the navicular bone is initially flattened and sclerotic and later becomes fragmented, before reossification. Bilateral foot radiographs comparing the affected side with the unaffected side help assess progression.
Treatment of Köhler Bone Disease
Rest and analgesics
Sometimes a cast
The course is chronic, but the disease rarely persists ≥ 2 years.
Rest, pain relief, and avoiding excessive weight bearing are required (1). The condition usually resolves spontaneously with no long-term sequelae.
In acute cases, a few weeks of wearing a below-knee walking plaster cast, well molded under the longitudinal arch, may help.
Довідковий матеріал щодо лікування
1. National Organization for Rare Disorders (NORD): Köhler Disease. Accessed August 1, 2025.
