Case Study 6: Arch Pain in an 8 Year old (Kohler’s Disease)

An 8 year old presented with complaints of pain in his arch. The pain was only present on the right side and was worse with activity. When the arch was irritated after playing sport it would throb for the next few days.

The navicular bone was point tender. Performing an ultrasound of the navicular indicated that the right navicular bone was smaller than the left.

Kohler's Disease Ultrasound

To clarify the findings on the ultrasound an Xray was ordered. This showed that the right navicular bone was fragmented and smaller when compared to the left.

The arch pain was caused by Kohler’s Disease also known as avascular necrosis of the navicular.

Kohler’s disease is a rare disorder but the pain  usually resolves within a year and the navicular regains its size, density and structure.

Treatment is designed to reduce the pain this can be achieved with:

  • Orthotics
  • More supportive shoes
  • Stiff shoes
  • Cast immobilisation if pain is severe

Surgery is not indicated in the treatment of Kohler’s disease.

By changing the patients shoes and taping the foot the pain resolved. If the pain persists orthotics would be the next line of treatment.


The Ankle, Foot and Orthotic Centre’s Northcote Podiatrists can help you with all lower limb complaints, including Kohler’s Disease Make an appointment to get your foot and ankle pain under control.

Expert Podiatrists and Orthotists in the treatment of Kohler’s Disease servicing the areas of Northcote, Thornbury, Fitzroy, North Fitzroy, Carlton, North Carlton, Alphington, Fairfield, Brunswick, Coburg and Preston

Call The Ankle, Foot and Orthotic Centre Podiatry Northcote for further advice on professional management and treatment options.