Kohlers disease, is an osteochondrosis of the growth ossification centers in children beginning as a degeneration or necrosis followed by regeneration or recalcification. Put simply the bone temporarily stops growing dyes back then new blood vessels are laid down and growing recommences. In the case of navicular (see anatomy) osteochondoris, the navicular becomes sclerotic and fragmented, eventually becoming flattened into a disc shape (visible on x-ray), with resultant re-shaping of the navicular into its original shape or a deformed one
It is diagnosed both by clinical findings and x-ray only occurring in young children with an approximate age of 5.  The navicular bone can be seen on x-ray film at approximately 18 to 24 months of age in girls, and between 30 to 36 months of age in boys, which corresponds to the normal development time of the navicular. The shape and density of the navicular is closely related to its time of appearance on x-ray  a navicular which is visible at the normal age range is likely to appear with a smooth outline and uniform density. This is not the case in a navicular which becomes visible on x-ray later on, here the navicular usually has an irregular outline, increased density and is often fragmented or flattened.  The vascular supply of the navicular is formed by a dense network of arteries which penetrate the navicular in a circular or radial manner. 
Clinical assessment the area over the navicular bone will be red warm and tender, no history of trauma to the area will be evident. The disease is self limiting that is once the area changes from cartilage to bone the pain will disappear.
If your child complains of pain in the foot it is well worth having it checked out by a Podiatrist.











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Page last updated 14 October, 2007