Kohler’s 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.

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

What is Kohler’s Disease?

Kohler disease or avascular necrosis of the navicular bone. It 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.

What Causes Kohler’s Disease?

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

Diagnosis of Kohler’s 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 Ankle, Foot and Orthotic Centre. The navicular is typically smaller and fragmented when comparing the the other side.

Kohler's Disease

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

Treatment of Kohler’s Disease

Kohler’s 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 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.

What else could it be? (differential diagnosis)

Other problems that can cause similar pain to Kohler’s Disease include:

Tibialis anterior tendinopathy

Tibialis posterior tendon dysfunction


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.