(See also Overview of Bone Disorders in Children Overview of Bone Disorders in Children Bone disorders can be caused by injury, infection, or cancer, be inherited, occur as part of a child’s growth, or occur for no known reason. Some bone disorders can cause pain and difficulty... read more .)
Köhler bone disease is an osteochondrosis, which is a group of disorders of the growth plate of bones Overview of Bone Disorders in Children Bone disorders can be caused by injury, infection, or cancer, be inherited, occur as part of a child’s growth, or occur for no known reason. Some bone disorders can cause pain and difficulty... read more that occur when the child is growing rapidly. Doctors are not sure what causes osteochondrosis, but the disorders do seem to run in families. Osgood-Schlatter disease Osgood-Schlatter Disease Osgood-Schlatter disease is painful inflammation of the bone and cartilage at the top of the shinbone (tibia). This disease is caused by overuse of the leg. Typical symptoms include pain, swelling... read more , Legg-Calvé-Perthes disease Legg-Calvé-Perthes Disease Legg-Calvé-Perthes disease involves destruction of the hip in children. This disease is caused by a poor blood supply to the upper growth plate of the thighbone near the hip joint. Typical symptoms... read more , and Scheuermann disease Scheuermann Disease Kyphosis is an abnormal curving of the spine that causes a humpback. (See also Overview of Bone Disorders in Children.) The upper back normally curves forward somewhat. Some children have a... read more are other osteochondroses.
Köhler bone disease is caused by a poor blood supply to the tarsal navicular bone. The poor blood supply causes the tarsal navicular bone to die and collapse. Why the blood supply is poor is not known.
Köhler bone disease usually affects children aged 3 to 5 years (more commonly boys) and typically affects only one foot. The foot becomes swollen and painful, and the arch of the foot is tender. Weight bearing and walking increase discomfort, and the child’s manner of walking (gait) is impaired.
Bones of the Foot
 |
Diagnosis of Köhler Bone Disease
X-rays
X-rays Plain X-Rays X-rays are high-energy radiation waves that can penetrate most substances (to varying degrees). In very low doses, x-rays are used to produce images that help doctors diagnose disease. In high... read more of the foot show that the navicular bone is initially flattened and hardened and later breaks into fragments before healing and hardening back into bone. X-rays comparing the affected side with the unaffected side help assess how far the disease has progressed.
Treatment of Köhler Bone Disease
Rest and pain relievers
Sometimes a cast
Köhler bone disease rarely lasts more than 2 years. Rest and pain relief are required, and excessive weight bearing must be avoided. This disease usually resolves without treatment and without any long-term consequences.
In severe cases, having the child wear a below-knee walking plaster cast Immobilization for a few weeks may help. Crutches are often not needed with a walking cast.
