Osgood-Schlatter disease

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Lateral view X-ray of the knee tibial with overlying soft tissue swelling.

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

Nontraumatic/Subacute

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

See Also

References