27May2018

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Köhler Disease- Drug Today Medical Times

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Some children, at a critical time during their growth period, develop a rare bone disorder of the foot, known as Köhler disease, arising due to stress-related compression.

Some children, at a critical time during their growth period, develop a rare bone disorder of the foot, known as Köhler disease, arising due to stress-related compression. It affects 2 in every 100 individuals. The main characteristics of this disease are limping due to pain and swelling in one foot.

The children mostly affected belong to the age of one to ten years with a peak occurring at ages 3 to 7 years. Males are affected five times more as compared to females. Most of the affected children grow out of the disorder, and regain their bone size, density and structure within a year. It is typically a self-limiting condition with intermittent symptoms for 1-3 years after diagnosis depending on activity.

The foot becomes tender along the length of the arch and putting weight on the foot, or walking, is difficult, causing further discomfort and a limp. The Köhler disease can be asymptomatic and hence the patient may not have any complaint. Symptoms of Köhler include pain in dorsomedial mid-foot, swelling, warmth, redness and point tenderness over the navicular.

The flow of blood to one of the bones in the foot (navicular bone) is interrupted, resulting in progressive degeneration of navicular bone. The exact cause of Köhler disease is unknown. However orthopedics linked Köhler to an injury in the area around the navicular bone in the foot or may be the result of delayed bone formation or ossification.

The Köhler disease is diagnosed with an X-ray of the foot and the presence of weight-bearing pain in the middle of the foot. Supportive shoes and short-leg plaster casts are used as part of the treatment.

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