Osgood-Schlatter disease is osteochondrosis of the tibial tubercle, causing painful inflammation. Diagnosis is mainly clinical. Treatment includes analgesics and rest.
Osgood-Schlatter disease occurs between ages 10 years and 15 years and is usually unilateral. Although the disease is more common among boys, this status is changing as girls become more active in sports programs.
Etiology of Osgood-Schlatter disease is thought to be trauma due to excessive traction by the patellar tendon on its immature epiphyseal insertion, leading to microavulsion fractures.
Characteristic symptoms of Osgood-Schlatter disease are pain, swelling, and tenderness over the tibial tubercle at the patellar tendon insertion. There are no systemic manifestations.
Diagnosis of Osgood-Schlatter Disease
Clinical evaluation
Sometimes x-rays
Diagnosis of Osgood-Schlatter disease is by characteristic findings isolated over the tibial tubercle on examination.
Lateral knee x-rays may show fragmentation of the tibial tubercle. However, x-rays are not needed unless other disorders (eg, injury, joint inflammation) are suggested by pain and swelling extending beyond the area over the tibial tubercle or pain is accompanied by redness and warmth.
Treatment of Osgood-Schlatter Disease
Analgesics
Rest
Rarely immobilization, corticosteroid injection, and surgery
Resolution is usually spontaneous within weeks or months. Usually, taking analgesics and avoiding excessive exercise, especially deep knee bending, are the only necessary measures. Complete avoidance of sports is unnecessary.
Rarely, immobilization in plaster, intralesional injection of hydrocortisone, surgical removal of loose bodies (eg, ossicles, avulsed fragments of bone), drilling, and grafting are required.
