Title: Kohler's disease<br/>Author: Brian Corwell<br/><a href='http://umem.org/profiles/faculty/294/'>[Click to email author]</a><hr/><p>
        <strong>Kohler’s disease</strong></p>
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        Osteonecrosis of the tarsal navicular bone</p>
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        Affects children ages 4 to 7</p>
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                       4x more likely in males</p>
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        Can be painless or present with arch/midfoot pain and a limp (usually activity related)</p>
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                       Usually unilateral but can be bilateral (in up to 25%)</p>
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        <strong>PE:</strong> Tenderness to palpation over the length of the arch esp the medial navicular</p>
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        Swelling, warmth, redness</p>
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                       -Can be misdiagnosed as an infection</p>
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        X-ray: Sclerosis, collapse/flattening or fragmentation of navicular</p>
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        <strong>Treatment:</strong> Walking boot or short leg cast</p>
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        <a href="http://www.texasfootdoctor.org/images/kohlers%20xray.jpg">http://www.texasfootdoctor.org/images/kohlers%20xray.jpg</a></p>
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