Tut and Köhler Disease

By now you have probably read that the boy-king Tutankhamun suffered from a club foot and died from complications of malaria (TimesOnLine).

According to the examination, the actual disorder that he suffered from was Köhler disease II. And because it's rather rare I thought I'd gather and share some information about it.

First, per the Journal of the American Medical Association (JAMA), here are the results of genetic studies: Genetic fingerprinting allowed the construction of a 5-generation pedigree of Tutankhamun's immediate lineage. The KV55 mummy and KV35YL were identified as the parents of Tutankhamun. No signs of gynecomastia and craniosynostoses (eg, Antley-Bixler syndrome) or Marfan syndrome were found, but an accumulation of malformations in Tutankhamun's family was evident. Several pathologies including Köhler disease II were diagnosed in Tutankhamun; none alone would have caused death. Genetic testing for STEVOR, AMA1, or MSP1 genes specific for Plasmodium falciparum revealed indications of malaria tropica in 4 mummies, including Tutankhamun’s. These results suggest avascular bone necrosis in conjunction with the malarial infection as the most likely cause of death in Tutankhamun. Walking impairment and malarial disease sustained by Tutankhamun is supported by the discovery of canes and an afterlife pharmacy in his tomb.


Now, as for Köhler's disease, you should know that at least in modern times, it is quite rare. According to "Dr. Foot" Kohler's disease is a condition, where the navicular bone in the foot undergoes avascular necrosis. Avascular necrosis is a disease resulting from the temporary or permanent loss of the blood supply to the bones. Without blood, the bone tissue dies and causes the bone to collapse. For some unknown reason, typically in a child, the navicular bone in the foot loses its blood supply for a while. (You can see the results in the figure, above)

What's good news is that medical treatment is actually simple:

A weight-bearing, below-the-knee cast is recommended. Total cast time is approximately 6-8 weeks. The cast is better in moderate varus (10-15º) that is associated with moderate equinus (10-20º). In this position, the navicula is relaxed from posterior tibialis strain. Arch supports can be prescribed following the cast period and used for an average of 6 months. In mild cases, soft arch supports may be the only treatment necessary.

What's rather tragic that this option wasn't apparently offered to Tut.




Other Articles:

eMedicine

Dr. Foot