Osgood-Schlatter disease is an overuse syndrome of the pediatric population that results in traction apophysitis of the tibial tubercle.
Typically occurs during an adolescent growth spurt in young athletes who participate in sports that involve repeated knee flexion and forced extension. Males are affected more often than females.
Diagnosis is clinical; patients typically present with pain, swelling, warmth, and localized tenderness to palpation over the tibial tubercle.
Conservative treatment is successful in most patients and consists of activity modification, ice, stretching, and strengthening exercises.
Plain radiographs of the knee are used to rule out other lesions of the proximal tibia if pain is unilateral and/or severe and persistent.
Up to 10% of patients may experience pain as adults due to formation of a separate ossicle at the tibial tubercle.
Rarely, when this condition fails to respond to nonsurgical management, excision of the affected part of the tibial tubercle predictably relieves symptoms.
Osgood-Schlatter disease (OSD) is an overuse syndrome of the pediatric population that typically affects young athletes during their adolescent growth spurt. It presents with pain, tenderness to palpation, and swelling directly over the tibial tubercle. It is typically a self-limiting condition that resolves after a period of activity modification, with ultimate resolution occurring when patients reach skeletal maturity.
History and exam
Key diagnostic factors
- pain at the tibial tubercle
- localized tenderness
Other diagnostic factors
- activity limitation
- localized swelling
- localized warmth
- prominence of the tibial tubercle
- pain at the tubercle with resisted knee extension
- adolescent males
- athletic participation
- history OSD in the contralateral knee
- high position of the patella (patella alta)
- more proximal/broader tibial attachment of the patella tendon
- increased external tibial torsion
1st investigations to order
- plain radiographs
Investigations to consider
progressive or late stage
persistence of pain into late adolescence or adulthood
- Fracture of the tibial tubercle
- Fat pad hypertrophy/impingement (Hoffa disease)
- Inferior patellar pole traction apophysitis (Sinding-Larsen and Johansson syndrome)
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