Discussion of Köhler disease
- Kohler disease is avascular necrosis of the navicular bone occurs.
- This disorder is far more common in boys than in girls.
- Most frequent in children aged 5-10 years.
- The etiology is unknown. Nevertheless, a vascular incident and a delayed bone age have been implicated.
- Treatment: a weightbearing below-the-knee cast is recommended. Total cast time is approximately 6-8 weeks.
- If pain persists 6 months after casting, an MRI or CT scan is necessary to exclude a tarsal coalition.
 Imaging Findings for Köhler disease
- Patchy increases in radiodensity, bone fragmentation with multiple ossific nuclei, and soft tissue swelling are evident on radiographs