Osgood-Schlatter Disease is a very common ailment seen in adolescents active in athletics, commonly affecting those experiencing a growth spurt during puberty. For this reason, it often affects females age 10-13 and males age 12-14. Osgood-Schlatter Disease results from the inflammation of the area just below the knee, the attachment site of the patellar tendon on the tibia.
What Is Osgood-Schlatter Disease?
In growing children, bones have an area towards the ends made of cartilage called “growth plates.” When children grow, these cartilaginous areas turn into solid bone once they reach their final height. Depending on their locations, some growth plates double as attachment sites for tendons. Osgood-Schlatter Disease occurs at the attachment site of the quadriceps muscles and tibial tubercle. The tibial tubercle is a bony bump that covers the growth plate at the end of the tibia. When running or jumping, the quadriceps pull on the patellar tendon, resulting in a pull on the tibial tubercle. In some active children, this repeated action causes inflammation of the growth plate, resulting in a large painful bump below the knee called Osgood-Schlatter Disease.
Adolescents experience growth spurts due to the development of tendons, bones, muscles and ligaments. Physical activity, such as running and jumping, further increases the pressure on the joints and leads to inflammation.
Causes
- Overuse of the knee joint
- Sports activities
- Changing direction rapidly while running or jumping
- Direct injury to the knee
- Detachment of a piece of bone from the tibia due to the pull exerted by the ligaments
- Tight quadriceps or hamstring muscles
What Are Symptoms of Osgood-Schlatter Disease?
Symptoms of Osgood-Schlatter Disease typically remain uniform throughout cases and arise in either one or both knees. Recreational activities with heavy running or jumping may exacerbate symptoms.
The most common symptoms of Osgood-Schlatter Disease:
- Knee pain, below the knee (at the tibial tubercle)
- Swelling at the tibial tubercle
- Tight quadriceps and hamstring muscles
Other symptoms may include:
- Prominent outgrowth of the tibial tubercle in the form of a lump
- Tenderness in the knee joint
- Pain may get aggravated during physical activity
- Instability
- Redness
- Locking of the knee
- Inability to kneel down
- Limping
How Do You Treat Osgood-Schlatter Disease?
Diagnosis
When diagnosing Osgood-Schlatter Disease, a physician conducts a physical exam. In many cases, physicians order X-rays as a form of diagnostics to rule out any other potential knee issues.
- Clinical examination of the knee
- Evaluation of the child’s medical history and symptoms
- X-ray imaging may be conducted to rule out other possible causes of knee pain
- The patient may be asked to move the leg in different directions to assess the severity of problem
- Blood tests
- MRI scan to evaluate damage to soft tissues
- Bone scan may be recommended by the orthopedic doctor
Treatment
To treat Osgood-Schlatter Disease, a physician often prescribes non-steroidal anti-inflammatory medication (NSAIDs) and a proper stretching regimen. Stretching the quadriceps and hamstring muscles allows increased mobility with less pulling on the tibial tubercle, resulting in decreased pain. A physician may also recommend a small brace to apply pressure to the area and relieve pain. In rare cases, the growth plate can potentially pull away from the tibia which may require surgery.
- Rest with the leg elevated at chest level
- Limit physical activity until the symptoms subside
- Perform exercises to stretch to strengthen the quadriceps
- Prescription of anti-inflammatory medicines
- Use of patellar tendon strap
- Application of ice packs at regular intervals
- Wear protective gear during sports to prevent knee injury
- Compression with an elastic bandage
- Physical therapy may be helpful to restore the range of motion of the knee
- Surgery may be required if the problem does not subside even after the patient attains adulthood.
Osgood-Schlatter Disease typically resolves once the child finishes growing; however, a bony prominence may remain present.
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