Köhler disease

Description

Köhler disease is a rare, self-limiting, avascular necrosis (osteonecrosis) of the navicular bone in children. Distinct from Müller-Weiss disease, a complex idiopathic foot condition with deformity of the tarsal navicular presenting in adulthood

Navicular avascular necrosis (Köhler disease) in a 5 year old male

Right navicular avascular necrosis - 5 year old male
Right navicular avascular necrosis
Left normal navicular comparison - 5 year old male
Left comparison – normal navicular 

Spontaneous adult onset osteonecrosis of the tarsal navicular is known as Mueller-Weiss syndrome (also Brailsford disease)


History of Köhler disease

1908 – First described by German radiologist Köhler in his MWW article Uber eine häufige, bisher anscheinend unbekannte Erkrankung einzelner kindlicher Knochen [About a common, so far apparently unknown disease of individual children’s bones]

Köhler disease. Erkranktes os naviculare, Kohler 1908
Fig 3. Erkranktes os naviculare, Kohler 1908

Es handelte sich um Knaben im Alter von 5-9 Jahren (..) Alle drei Patienten klagten über mehr oder weniger heftige Schmerzen in der Gegend des Os naviculare (…) Die Röntgenuntersuchung ergab einen recht eigenartigen (…) Befund. Ueberall zeigte sich das Os naviculare in die Augen fallend erkrankt, während alle anderen Knochen des Fusses einen normalen Anblick boten. Das Navikulare war in vierfacher Beziehung verändert, und zwar in seiner Grösse, seiner Gestalt, seiner Architektur und seinem Kalkgehalt.

Der Krankheitsverlauf zog sich auf 2-3 Jahre hin (…) es erfolgte Heilung (…) nicht nur im klinischen Sinne, sondern wie die Röntgenbilder anzunehmen zwingen, auch in anatomischem Sinne. Die Prognose des Leidens ist also durchaus günstig zu stellen.

Köhler, 1924

In question were young lads aged 5-9 years old (…) All three patients complained of more or less severe pains in the region of the navicular bone (…) The Röntgen examination demonstrated a most peculiar (…) finding. Everyhwere tha navicular bone appeared diseased, whilst all othe bones of the foot presented normally. The navicular was changed in four aspects, namely its size, shape, architecture, and calcification.

The disease took its course in 2-3 years (…) healing was evident(…) not only in the clinical sense, but also in the anatomical sense, as the X-rays force us to acknowledge. The prognosis of this suffering is therefore quite favourable.

Köhler, 1924


Associated Persons

Alternative names
  • Kohler disease, Koehler disease

References

Original articles

Review articles


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the names behind the name

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and informatics. Asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | vocortex |

Resident medical officer in emergency medicine MB ChB (Uni. Dundee)  MRCS Ed. Avid traveller, yoga teacher, polylinguist with a passion for discovering cultures.

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