Updated: 12/5/2020

Osgood-Schlatter Disease

0%
Topic
Review Topic
0
0
N/A
N/A
Questions
3
0
0
100%
0%
Evidence
1
0
0
Topic
Snapshot
  • A 15-year-old boy presents to his pediatrician with left knee pain. He denies any trauma to the knee. He plays football for his high school team and attends practice regularly. On physical exam, the tibial tubercle is pronounced and there is tenderness to palpation over the affected area. The patient reports pain upon resisted knee extension.
Introduction
  • Clinical definition
    • describes an apophysitis of the tibial tuberosity
  • Epidemiology
    • demographics
      • male:female ratio
        • more common in males
      • age bracket
        • 12-15 years of age in boys
        • 8-12 years of age in girls
    • risk factors
      • participating in sports
  • Pathogenesis
    • repetitive traction of the apophysis of the tibial tuberosity results in microtrauma and micro-avulsion
      • the proximal patellar tendon insertion separates from the tibial tubercle
        • during healing there is callous deposition that leads to a pronounced tubercle
  • Prognosis
    • self-limiting
    • responds well to conservative management
Presentation
  • Symptoms
    • anterior knee pain
  • Physical exam
    • inspection
      • enlarged tibial tubercle
      • tenderness over tibial tubercle 
    • provocative test
      • pain on resisted knee extension
Imaging
  • Radiographs
    • recommended views
      • lateral radiograph of the knee
    • findings
      • irregularity and fragmentation of the tibial tubercle  
Studies
  • Diagnostic criteria
    • a clinical diagnosis
Differential
  • Sinding-Larsen-Johansson syndrome
    • chronic apophysitis or minor avulsion injury of the inferior patellar pole
  • Osteochondroma of the proximal tibia
  • Tibial tubercle fracture 
  • Patellar tendonitis 
    • also an overuse injury (jumping, running)
    • chronic, episodic anterior knee pain
    • worsened with stairs or prolonged sitting
    • localized tenderness along the patellar tendon, at the inferior pole of the patella
Treatment
  • Conservative
    • rest, analgesics, ice, and physical therapy 
      • indication
        • first-line treatment for Osgood-Schlatter disease
  • Operative
    • ossicle resection and/or excision of the tibial tuberosity
      • indication
        • considered in patients who do not respond to conservative managament and after skeletal maturity
Complications
  • Tubial tubericle prominence persists
  • Genu recurvatum

Please rate topic.

Average 5.0 of 4 Ratings

Questions (3)
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK

(M2.OR.17.4679) A 13-year-old is brought into your office by his father because of left knee pain. The father states that the patient has no medical conditions and that his birth history is normal. He is an avid basketball player and recently started playing for his school's basketball team. On exam, his vitals are within normal limits. There is no erythema or effusion in any of the knee compartments, and the patient has a full range of motion. The patient has full strength on flexion and extension, but does have pain on the tibial tubercle with palpation and resistance to knee extension. A lateral view of his left knee is shown in the radiograph in Figure A. What is the most likely cause of his knee pain?

QID: 107284
FIGURES:
1

Tibial tubercle apophysitis

50%

(2/4)

2

Patellar tendonitis

0%

(0/4)

3

Patellofemoral arthritis

0%

(0/4)

4

Patellar stress fracture

25%

(1/4)

5

Tibial stress fracture

25%

(1/4)

M 6 D

Select Answer to see Preferred Response

Evidence (1)
EXPERT COMMENTS (0)
Private Note