Kohler disease

Case contributed by Jeremy Jones
Diagnosis almost certain

Presentation

Right foot pain, typically when doing exercise. No specific history of trauma.

Patient Data

Age: 6 years
Gender: Male
x-ray

The left navicular is small and sclerotic. Features here are consistent with avascular necrosis of the navicular - Kohler's disease.

Case Discussion

There is asymmetry of the navicular bones with a small and sclerotic navicular on the left. Features here are of Kohler disease which is the epnonymous name given to avascular necrosis of the navicular.

The child presented with right foot pain. The abnormality here is on the left suggesting that it is asymptomatic and an incidental finding. No cause for right foot pain is demonstrated on these images.

The navicular may be dense during development, but with degree of asymmtry here is a help to diagnosis.

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