OSGOOD-SCHLATTER DISEASE
 
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OSGOOD-SCHLATTER DISEASE

 

DEFINITION:

An osteochondritis involving the tibial tuberosity resulting in knee pain and swelling.

EPIDEMIOLOGY:

  • incidence: ?
  • age of onset:
    • during pubertal growth spurt
  • risk factors:
    • M > F
    • active in sports
    • recent growth spurt

PATHOGENESIS:

1. Background

  • activity causes microtrauma at the tibial tuberosity at the site of attachment of the patellar tendon to produce a traction apophysitis
  • considered an overuse syndrome not involving avascular necrosis or an inflammatory process

CLINICAL FEATURES:

1. Knee

1. Knee Pain

  • around the tibial tuberosity with swelling
  • increases with activity (running, jumping, up/down stairs, kneeling)
  • limp

2. Complications

  • may result in the detachment of cartilage fragments from the tibial tuberosity

INVESTIGATIONS:

1. Imaging Studies

1. Skeletal X-Rays

  • 1. Tibial Tuberosity
    • acute - soft tissue swelling and thickened ligamen-tum patellae
    • chronic - ossicle formation
    • severe - free particles of bone anterior and superior to the tibial tuberosity

    • MANAGEMENT:

    1. Rest

    • decrease level of activity
    • may use knee-immobilizer splint
    • usually self-limiting and resolves over months
    • chronic in 5-15% of cases with persistent tenderness, swelling, and ossicle formation which may need surgical removal

    2. Medications

    • local corticosteroid injection not indicated

     

     

     

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