Osgood-Schlatter disease is a painful condition of the tibial tuberosity. The tibial tuberosity is a normal slight elevation of bone (known at the tibial tubrcle) on the anterior (front) and proximal part of the shin bone (tibia). The patellar tendon attaches the anterior quadriceps muscle (used to straighten the knee) to the tibia at this point.
Overuse of the quadriceps muscle can cause repeated strain on the attachment of the patellar ligament to the growing tibia. The tibia hasn't finished growing and isn't quite strong enough to withstand the strain on it. This can cause redness and soreness where the ligament attaches. Healing bone (callus) then forms which may cause a hard bony bump to develop.
The condition usually occurs during the growth spurt period in adolescents. Pain may last a few months and may recur until a child's growth is completed. Boys are affected more than girls, and this could be due to differing activity patterns. It is more common with sports requiring overuse of the quadriceps muscle e.g. football.
- The patient usually presents with a gradually increasing pain and swelling below the front of the knee.
- Pain usually increases by activities that extend (straighten) the knee against resistance, particularly running or jumping and is relieved by rest.
This condition is usually diagnosed just by clinical examination.
- A bony bump that is particularly painful when pressed may appear on the upper edge of the tibia ,below the knee cap.
- Pain is provoked by knee extension against resistance or by hyperflexing the knee with the person lying prone.
- An X-ray mey be done to confirm the diagnosis and to exclude other causes of knee pain.
Treatment may include:
- Stretching and strengthening exercises for the quadriceps, hamstring and calf muscles.
- Medications, including painkillers and anti-inflammatory drugs
- Surgery – only in extreme cases and only once growth has ended. This can involve removing unhealed areas of flakes of bone.
The condition usually resolves spontaneously around age 14 for girls and age 16 for boys