Introduction

Osgood Schlatter Disease (OSD) is a painful condition in which there is injury to the tibial tuberosity where it joins with the patellar tendon.

It is commonly found in adolescents, particularly who participate in a lot of sporting activities during their growth spurt.

Symptoms typically resolve with rest and are exacerbated by activity. Episodes last from a few weeks to a few months, and an individual can have multiple episodes.

Pathology

The patellar tendon causes damage to the tibial tuberosity due to a combination of increased quadriceps muscle strength, immaturity of the bone and repeated strain. Inflammation and increased bone growth around the tuberosity sometimes creates a palpable bony nodule just below the patellar tendon that may be painful.

Diagnosis

Diagnosis is usually clinical. A suggestive history can be confirmed with tenderness of the tibial tubersoity.

X-rays, if performed (not usually indicated) can also confirm the diagnosis by showing thickening over the tibial insertion of the patellar tendon, or in more severe cases deformity and fragmentation of the patellar tendon.

Osgood Schlatter Disease x-ray

Osgood Schlatter Disease x-ray showing fragmention of the tibial tuberosity in a more severe case

Differential Diagnoses

Management

There is no specific treatment for Osgood-Schlatter disease.  Rest and ice packs may help symptoms. Avoidance of aggravating activities is important whilst there is still pain.
use of paracetamol or anti-inflammatories may also help to improve symptoms.
After the initial pain settles then then stretching and strengthening exercises of the quadriceps, hamstrings and calves may be useful  to prevent flare-ups. This is often done under the supervision of a physiotherapist.
In some cases with an underlying pronation disorder, orthotics may help to correct this and could reduce the risk of recurrence.
Virtually all cases resolve after puberty.

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