Osgood-Schlatter disease

Case contributed by Adam Eid Ramsey, MD

Presentation

Anterior knee pain and swelling in an adolescent exacerbated by athletic activities.

Patient Data

Age: 15 years
Gender: Male

Left knee

x_ray

There is some degree of fragmentation and irregular ossification of the tibial tuberosity as well as soft tissue swelling consistent with Osgood-Schlatter disease.

Case Discussion

This patient has Osgood-Schlatter disease, a common cause of knee pain in active children with immature skeletons. It occurs as a result of abnormal development, injury, or overuse of the growth plate and the surrounding ossification centers. Osteochondrosis is a more general term for this condition, which can occur at growth plates around other joints, including the hip, foot, elbow, and back. In Osgood-Schlatter disease repetitive traction of the patellar tendon on the tibial tubercle ossification center leads to inflammation and pain. Imaging is not required to make the diagnosis when patients present with typical symptoms and physical examination findings. Radiographs may be obtained if there is uncertainty about the diagnosis. Radiographic findings in Osgood-Schlatter disease include soft-tissue swelling and fragmentation of the tibial tubercle.

This condition is self-limited and treatment consists of activity modification and the use of acetaminophen or NSAIDs. An orthopedic referral is indicated if symptoms persist in a patient with a mature skeleton.

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