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Osgood–Schlatter disease and tibial stress fracture

Case contributed by Mahmoud Ibrahim Mekhaimar
Diagnosis almost certain

Presentation

One month of left medial leg pain. No previous history of trauma or surgery.

Patient Data

Age: 16 years
Gender: Male

Fragmentation of the left tibial tuberosity associated with mild soft tissue swelling.

A horizontal fracture line is seen in the proximal tibial metaphyses associated with subtle periosteal reaction, most consistent with a stress fracture.

CT confirms plain film findings of:

  • fragmentation of the left tibial tuberosity associated with mild soft tissue swelling
  • horizontal (stress) fracture line in the proximal tibial metaphyses associated with periosteal reaction

Case Discussion

The patient gave history of playing football and usually works in a restaurant. 

On examination the patient demonstrated localized tenderness and swelling over the left tibial tuberosity, classic clinical findings for Osgood-Schlatter disease.  The condition commonly affects growing adolescents and is seen most frequently in boys from age 10-15 1

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