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A child with Kohlerâs disease may present similarly to a child with a foot injury. An examination will reveal pain and tenderness over the dorsomedial midfoot, with or without local skin changes. Affected children typically walk with a limp or antalgic gait, with weight bearing on the lateral side of the foot.
The authors suggest that the development of the condition in identical twins may imply that there is an unknown genetic predilection for the disease. Kohlerâs Disease Symptoms To Be Aware Of. Symptoms of Kohlerâs disease are usually mild and may include: Swelling; Pain and tenderness; Limping; The pain may be intermittent and may worsen after activity.