Marion Dimigen MBChB, Presenter: Nothing to Disclose

Graham Wilkinson MBCHB, Abstract Co-Author: Nothing to Disclose

Raghu Vikram MBBS, Abstract Co-Author: Nothing to Disclose

Radiographic abnormalities of the tarsal navicular are common but their relationship to Kohler’s disease is uncertain. The objective of the study was to determine the incidence of radiographic abnormalities of the navicular and their association with non-traumatic foot pain.

Radiographs of 921 children having foot radiography over a two year period were reviewed retrospectively and 385 patients with developing ossific nuclei of the navicular formed the study population. Abnormal radiographic features of the navicular were compared to clinical records.

Of the study population, 57 (14%) had some radiographic navicular abnormalities i.e. sclerosis, bipartite, flattening and delayed ossification of the navicular bone. Fifteen (3.9%) patients had two or more of these features, consistent with Kohler’s disease. Only 4 (27%) of the Kohler’s type patients presented with non-traumatic foot pain compared with 77 (21%) of the non-Kohler’s patients. The patient’s with Kohler’s disease were not significantly more likely to present with non-traumatic foot pain than the rest of the study population.

Radiographic abnormalities of the tarsal navicular are common and are not statistically associated with non-traumatic foot pain in this study. The features Kohler described may be normal variants

The study confirms that Kohler's disease is a radiological and not a clinical diagnosis.

Dimigen, M, Wilkinson, G, Vikram, R, Kohler's Disease of the Tarsal Navicular Bone: Does It Exist?.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8009558.html