Limping child
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v33.i3.27856Keywords:
avascular necrosis, Kohler’s disease, limping, midfoot painAbstract
Kohler’s disease is a rare osteochondrosis in children resulting from avascular necrosis of the navicular bone. The most common clinical signs are midfoot pain associated with limping, difficulty with weight bearing, and localized edema. Diagnosis requires the presence of symptoms associated with radiographic changes of the foot, namely flattening of the navicular bone with irregular bone sclerosis and sometimes fragmentation. Treatment is conservative and includes rest, pain control, and sometimes immobilization. The prognosis is excellent, with the possibility of resolution of symptoms within three months, although radiologic recovery may take four years.
The authors report the case of a four-year-old boy with right foot pain and limping for several weeks. Radiograph of the right foot showed significant flattening and sclerosis of the navicular bone. Conservative treatment with analgesia and rest was recommended, with complete symptom resolution. Radiographically, the navicular bone had almost regained its normal anatomic shape two years later. The child remains without limitation of right foot mobility and without limping.
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