> Osgood-Schlatter Disease
What is Osgood-Schlatter Disease?
is a painful knee condition seen primarily in young,
active athletes. It stems from repeated stress on the
spot just below the kneecap, called the tibial tubercle,
where the patellar tendon inserts into the shinbone
(tibia). Osgood-Schlatter disease is related to growth
and growth spurts, and primarily affects boys aged 10
to 15 and girls aged 8 to 13. Pain associated with the
condition usually runs its course in two years or less,
ending when the tibial tubercle has fully developed
and has changed from cartilage into bone. The severity
of symptoms can vary widely. Some athletes with mild
symptoms do not have to decrease their level of play,
while others with severe symptoms find they have to
discontinue playing sports for several weeks or months.
While growth spurts are a major contributing
factor to Osgood-Schlatter disease, many activities
can aggravate the condition. Sports that require jumping
and cutting, such as soccer, basketball, volleyball,
and gymnastics, fall into this category. Ultimately,
it is caused by persistent inflammation of the insertion
of the patellar tendon (enthesitis). General physical
activity can contribute to Osgood-Schlatter disease.
Studies have shown that the incidence in physically
active boys and girls can be four or five times greater
than in those who are not active.
Osgood-Schlatter disease can leave
a noticeable bump on the knee just below the kneecap
after symptoms have receded. Although seldom, some sufferers
can experience pain when kneeling, even as adults. Occasionally,
a patient suffering from Osgood-Schlatter disease will
develop a small bone, or ossicle, on the patellar tendon,
which can be removed through surgery. In rare cases
where tenderness in the area persists into adulthood,
part of the tibial tubercle can be removed through surgery.
There are usually three parts to an
orthopedic evaluation: medical history, physical examination,
and tests your physican may order.
will likely ask you to describe in detail the nature
of your pain: how acute it is, where it is centered,
when it occurs, aggravating and relieving factors, and
how long it lasts. This will provide clues that can
help him suggest a treatment program. Physicians also
typically ask about other conditions, such as diabetes
and allergies, and medications currently being taken.
It is particularly important to tell your doctor the
extent of your athletic activities and goals, since
Osgood-Schlatter disease affects physically active adolescents.
| PHYSICAL EXAMINATION
After you have given your medical
history and described your symptoms, your doctor will
check for tenderness and swelling around the bone just
below your kneecap, called the tibial tuberosity. He
may also perform further physical tests to rule out
other conditions, such as Sinding-Larsen-Johansson syndrome,
patellofemoral pain syndrome, Perthes' disease, or other
If the physical exam suggests a condition other than,
or in addition to, Osgood-Schlatter disease, an X-ray
may be ordered. The X-ray can rule out such causes as
a fracture of the tibial tubercle (the bump on your
shinbone where your patellar tendon attaches), a tumor
or infection, or osteochondritis dissecans, which is
an abnormality affecting the knee's articular cartilage
and the bone that lies beneath it.