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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.
Of the 600 children seen at the Hershey clinic, Duda said 90 percent have tics that do not require medication, about 5 percent to 9 percent of the children take a neurological mediation that controls their tics, and less than 1 percent have a debilitating form of Tourette syndrome.