Köhler disease

The Kohler's Disease - Albau is the avascular necrosis of the navicular ( scaphoid bone of the tarsus ).

Clinical features, diagnosis and differential diagnosis

There are stress-related pain in the midfoot. On clinical examination, one finds tenderness and occasional swelling over the navicular bone. In the X-ray impress a disc-shaped narrowing and increasing bone density in the navicular bone. A clod -like decay of the bone is possible. Furthermore, there is a joint space widening to the talus and navicular bone. The differential diagnoses include posttraumatic Vaskularisationsstörung, tumor, inflammation, navicular bipartitum.

However, the absence of clinical symptoms in only striking structure of the navicular bone in the radiograph, is usually a harmless normal variant before ( Ossifikationsvariante )

Treatment and prognosis

For acute pain, immobilization in a short leg cast and relief for 8 to 12 weeks, then insoles to support the longitudinal arch. Usually a restitutio ad integrum occurs. A secondary osteoarthritis is possible.