Osgood Schlatter disease


background

  • Common cause knee pain - esecially 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 epiphyseal plate

Examination

  • Tibial tuberosity prominnce ± tenderness
  • Pain triggered by resisted knee extension
  • Clinical Dx - no need for x-ray

Management

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

Consider

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


Content by Dr Íomhar O' Sullivan. Last review Dr ÍOS 28/11/22