Osgood-Schlatter’s disease

Last Updated on by FRCEM Intermediate

Overview

  • Common cause knee pain – especially adolescents
  • Painful overuse of the tibial tuberosity
  • Gradual onset
  • Max after sport, especially jumping (basketball)
  • Early Teens (growth spurts), M>>F
  • 30% bilateral
  • Repeated pull off (quads ligament) microfractures at the epiphyseal plate

Examination

  • Tibial tuberosity prominnce ± tenderness
  • Pain triggered by resisted knee extension

Radiology

X-ray: Clinical Dx – no need for x-ray- but show an enlarged and sometimes fragmented tibial tuberosity.

Management

  • Conservative
  • Reduce (usually no need to avoid completely) triggering activity but maintain activity (change sport etc)
  • Local ice therapy or NSAIDs PRN
  • Later physiotherapy to stretch hamstrings and iliotibial band
  • 90% will have symptom resolution by end of the teen’s growth spurt
  • ROUGH estimates e.g. compare with mean parental height, siblings height, menarche

Consider Other DDx if

  • Hx trauma
  • Constitutional symptoms
    • T °, ↓wt, malaise, arthralgia
    • Night pain, rest pain
  • Beware hip exam

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