Knee > Osgood-Schlatter Disease

What is Osgood-Schlatter Disease?

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.

Your doctor 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.

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 hip problems.

TESTS

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.

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