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Updated: Aug 23 2020

Osgood-Schlatter Disease

  • Snapshot
    • A 12-year-old boy presents to his pediatrician with right knee pain. He began playing basketball for his school a few months ago. On physical exam, there is a pronounced, tender tibial tubercle and tenderness to palpation over the affected area. The patient reports pain upon resisted knee extension.
  • Introduction
    • Clinical definition
      • describes traction 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 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
  • Treatment
    • Conservative
      • analgesics, ice, and physical therapy
        • indication
          • first-line treatment for Osgood-Schlatter disease
  • Complications
    • Tubial tubericle prominence persists
    • Genu recurvatum
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