Osgood-Schlatter disease: Difference between revisions
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==Background== | ==Background== | ||
[[File:Knee diagram2.png|thumb|Anatomy of anterolateral aspect of right knee.]] | |||
*Apophysitis of tibial tubercle resulting from repeated normal stresses or overuse | *Apophysitis of tibial tubercle resulting from repeated normal stresses or overuse | ||
* | *Patients are usually 10-15yr old | ||
*More commonly occurs in running or jumping athletes | *More commonly occurs in running or jumping athletes | ||
==Clinical Features== | |||
[[File:Gray1240.png|thumb|Showing tibial tubersoity.]] | |||
*Most cases are bilateral | *Most cases are bilateral | ||
**Although symptoms are commonly asymmetric | **Although symptoms are commonly asymmetric | ||
*Chronic, intermittent pain over the anterior aspect of knee and tibial tuberosity | *Chronic, intermittent pain over the anterior aspect of knee and tibial tuberosity | ||
*Pain aggravated by activity, improves | *Pain aggravated by activity, improves with rest | ||
*Prominence and soft tissue swelling over tibial tubercle | *Prominence and soft tissue swelling over tibial tubercle | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Knee DDX}} | {{Knee DDX}} | ||
== | ==Evaluation== | ||
[[File:osgood-schlatter-xray.png|thumb|Lateral view X-ray of the knee tibial with overlying soft tissue swelling.]] | |||
*Imaging is not typically necessary | |||
**If obtained shows nonspecific irregularities of tibial tubercle | |||
*Indications for knee xrays (to evaluate for avulsion fracture of the tibial epiphysis) | |||
**Swelling | |||
**Inability to actively extent the knee | |||
** decreased strength with knee extension, or inability to walk | |||
==Management== | |||
*Disease is self-limited | *Disease is self-limited | ||
**Most patients' symptoms respond to rest and temporary avoidance of offending activity | **Most patients' symptoms respond to rest and temporary avoidance of offending activity | ||
**Complete avoidance of activity is not essential | **Complete avoidance of activity is not essential | ||
*Immobilization is contraindicated | *Immobilization is contraindicated | ||
*NSAIDs | *[[NSAIDs]] | ||
*Apply ice after activity | *Apply ice after activity | ||
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*[[Knee diagnoses]] | *[[Knee diagnoses]] | ||
== | ==References== | ||
<references/> | |||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
[[Category:Orthopedics]] | [[Category:Orthopedics]] | ||
[[Category:Sports Medicine]] |
Revision as of 21:53, 21 May 2020
Background
- Apophysitis of tibial tubercle resulting from repeated normal stresses or overuse
- Patients are usually 10-15yr old
- More commonly occurs in running or jumping athletes
Clinical Features
- Most cases are bilateral
- Although symptoms are commonly asymmetric
- Chronic, intermittent pain over the anterior aspect of knee and tibial tuberosity
- Pain aggravated by activity, improves with rest
- Prominence and soft tissue swelling over tibial tubercle
Differential Diagnosis
Knee diagnoses
Acute knee injury
- Knee dislocation
- Knee fractures
- Meniscus and ligament knee injuries
- Patella dislocation
- Patellar tendonitis
- Patellar tendon rupture
- Quadriceps tendon rupture
Nontraumatic/Subacute
- Arthritis
- Gout and Pseudogout
- Osgood-Schlatter disease
- Patellofemoral syndrome (Runner's Knee)
- Patellar tendonitis (Jumper's knee)
- Pes anserine bursitis
- Popliteal cyst (Bakers cyst)
- Prepatellar bursitis (nonseptic)
- Septic bursitis
- Septic joint
- DVT
Evaluation
- Imaging is not typically necessary
- If obtained shows nonspecific irregularities of tibial tubercle
- Indications for knee xrays (to evaluate for avulsion fracture of the tibial epiphysis)
- Swelling
- Inability to actively extent the knee
- decreased strength with knee extension, or inability to walk
Management
- Disease is self-limited
- Most patients' symptoms respond to rest and temporary avoidance of offending activity
- Complete avoidance of activity is not essential
- Immobilization is contraindicated
- NSAIDs
- Apply ice after activity
Disposition
Discharge