Kohlers Disease (Avascular Necrosis of the Navicular)

What is Avascular Necrosis

Avascular necrosis is the death of bone tissue as a result of disruption to the blood supply in the bone.

Avascular necrosis is most commonly seen in the navicular bone, talus and also the second metatarsal.

What is Kohlers Disease

Kohler disease or avascular necrosis of the navicular is a rare, painful bone disorder. It is most commonly seen in children between two and nine years of age.

Kohler disease affects males five times more often than females. Typically, just one foot is affected.

Causes of Kohlers Disease

There is no known cause of Kohlers disease, it is thought that trauma may initiate the problem.

Diagnosis of Kohlers Disease

There can be pain, swelling, redness or warmth on the top of the foot. The diagnosis is confirmed by x-ray and a complete examination at the Foot and Ankle Centre of Victoria.

Symptoms can last for a few days or may persist for up to two years.

Treatment of Kohlers Disease

Kohler disease  usually resolves within a year and the navicular regains its size, density and structure.

Treatment is designed to reduce the pain this can be in the form of.

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

Surgery is not indicated in the treatment of Kohler disease.

What else could it be? (differential diagnosis)

Other problems that can cause similar pain to Kohlers Disease include:



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