Kohler disease
Encyclopedia
Köhler disease is a rare bone
disorder of the foot
found in children between six and nine years of age. The disease typically affects boy
s, but it can also affect girl
s. It was first described in 1908 by Alban Köhler
(1874–1947), a German
radiologist.
It is caused when the navicular bone
temporarily loses its blood
supply. As a result, tissue
in the bone dies and the bone collapses. When treated, it causes no long term problems. As the navicular bone gets back to normal, symptoms typically abate.
In February 2010 the Journal of the American Medical Association reported that the 19-year-old king Tutankhamun
may well have died of complications from malaria combined with Kohler disease II.
and swelling
in the middle part of the foot and usually limp as a result. Patients that walk with a limp tend to walk with increased weight on the lateral side of the foot. Also, there can be tenderness over the navicular. Patients often complain of pain over the apex.
An X-ray
of both feet is used to diagnose disease. The affected foot tends to have a sclerotic and flattened navicular bone.
. The cast is usually worn for 6 to 8 weeks. After the cast is taken off, some patients are prescribed arch support for about 6 months. Also, moderate exercise
is often beneficial, and physical therapy may help as well.
Prognosis for children with this disease is very good. It may persist for some time, but most cases are resolved within two years of the initial diagnosis.
Bone
Bones are rigid organs that constitute part of the endoskeleton of vertebrates. They support, and protect the various organs of the body, produce red and white blood cells and store minerals. Bone tissue is a type of dense connective tissue...
disorder of the foot
Foot
The foot is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is a separate organ at the terminal part of the leg made up of one or more segments or bones, generally including claws...
found in children between six and nine years of age. The disease typically affects boy
Boy
A boy is a young male human , as contrasted to its female counterpart, girl, or an adult male, a man.The term "boy" is primarily used to indicate biological sex distinctions, cultural gender role distinctions or both...
s, but it can also affect girl
Girl
A girl is any female human from birth through childhood and adolescence to attainment of adulthood. The term may also be used to mean a young woman.-Etymology:...
s. It was first described in 1908 by Alban Köhler
Alban Kohler
Alban Köhler was a German radiologist. Born in Petsa , he discovered a rare foot disorder found in children which was named Köhler disease in his honour. He died in Niederselters.-External links:* - whonamedit.com...
(1874–1947), a German
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...
radiologist.
It is caused when the navicular bone
Navicular bone
The navicular bone is a small bone found in the feet of both humans and horses.- Human anatomy :The navicular bone is one of the tarsal bones, found in the foot. Its name derives from the bone's resemblance to a small boat, caused by the strongly concave proximal articular surface...
temporarily loses its blood
Blood
Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....
supply. As a result, tissue
Biological tissue
Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...
in the bone dies and the bone collapses. When treated, it causes no long term problems. As the navicular bone gets back to normal, symptoms typically abate.
In February 2010 the Journal of the American Medical Association reported that the 19-year-old king Tutankhamun
Tutankhamun
Tutankhamun , Egyptian , ; approx. 1341 BC – 1323 BC) was an Egyptian pharaoh of the 18th dynasty , during the period of Egyptian history known as the New Kingdom...
may well have died of complications from malaria combined with Kohler disease II.
Symptoms
Sufferers experience painPain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
and swelling
Swelling (medical)
In medical parlance, swelling is the transient enlargement or protuberance in the body and may include tumors. According to cause, it may be congenital, traumatic, inflammatory, neoplastic or miscellaneous....
in the middle part of the foot and usually limp as a result. Patients that walk with a limp tend to walk with increased weight on the lateral side of the foot. Also, there can be tenderness over the navicular. Patients often complain of pain over the apex.
An X-ray
X-ray
X-radiation is a form of electromagnetic radiation. X-rays have a wavelength in the range of 0.01 to 10 nanometers, corresponding to frequencies in the range 30 petahertz to 30 exahertz and energies in the range 120 eV to 120 keV. They are shorter in wavelength than UV rays and longer than gamma...
of both feet is used to diagnose disease. The affected foot tends to have a sclerotic and flattened navicular bone.
Treatment
Treatment usually involves resting the affected foot, taking pain relievers and trying to avoid putting pressure on the foot. In acute cases, the patient is often fitted with a cast that stops below the kneeKnee
The knee joint joins the thigh with the leg and consists of two articulations: one between the fibula and tibia, and one between the femur and patella. It is the largest joint in the human body and is very complicated. The knee is a mobile trocho-ginglymus , which permits flexion and extension as...
. The cast is usually worn for 6 to 8 weeks. After the cast is taken off, some patients are prescribed arch support for about 6 months. Also, moderate exercise
Physical exercise
Physical exercise is any bodily activity that enhances or maintains physical fitness and overall health and wellness. It is performed for various reasons including strengthening muscles and the cardiovascular system, honing athletic skills, weight loss or maintenance, as well as for the purpose of...
is often beneficial, and physical therapy may help as well.
Prognosis for children with this disease is very good. It may persist for some time, but most cases are resolved within two years of the initial diagnosis.