Osteonecrosis, also referred to as avascular necrosis, refers to the death of cells within bone caused by a lack of circulation. It has been documented in bones throughout the body. In the foot, osteonecrosis is most commonly seen in the talus, the first and second metatarsals, and the navicular. Although uncommon, osteonecrosis has been documented in almost every bone of the foot and therefore should be considered in the differential diagnosis when evaluating both adult and pediatric foot pain. Kohler's disease is a rare, self-limiting, avascular necrosis of the navicular bone, first described in 1908. It is usually unilateral and most often affects boys. Its usual onset is between 4 to 5 years of age but can present as early as 2 years of age. Girls with this condition are often younger than boys, probably owing to earlier onset of ossification. In this case report we present the diagnosis and therapy of Kohlerís Disease of a 5-year-old boy who had Attention Deficit Hyperactivity Disorder. Our goal is elucidate the etiology of these cases and their relationship with behavioral disorders. Our goal is elucidate the etiology of these cases and their relationship with behavioral disorders.
Osteonecrosis of Navicula, Kohler Disease, attention deficit hyperactivity disorder (ADHD)