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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.
Type II, also called chronic infantile SMA, begins to affect children between 6 and 18 months old. This form can be moderate to more severe. Type III, also called Kugelberg-Welander disease or juvenile spinal muscular atrophy, begins to affect kids as early as 18 months of age or as late as adolescence. This is the mildest form of SMA in children. Type IV is the adult form of the disorder.