Osgood-Schlatter Disease

Osgood-Schlatter (say: "oz-good shlot-ter") disease is one of the most common causes of knee pain in young athletes. It also called osteochondrosis, Osgood-Schlatter disease is a painful, incomplete separation of the epiphysis of the tibial tubercle from the tibial shaft. Severe disease may cause permanent tubercle enlargement.

Causes

Osgood-Schlatter disease probably results from trauma, before the complete fusion of the epiphysis to the main bone has occurred (between the ages of 10 and 15). Such trauma may be a single violent action or repeated knee flexion against tight quadriceps muscle. Other causes include locally deficient blood supply and genetic factors.

Signs and symptoms

Children with Osgood-Schlatter disease have a tender, swollen bump just under their knee cap on the tibial tuberosity. Although usually just on one knee, both knees can also be affected.

Unlike other problems that cause knee pain, children with Osgood-Schlatter disease usually just have pain during certain activities, such as running, kneeling, jumping, squatting, and climbing stairs. Prolonged sitting sometimes also causes pain, although affected children can usually walk normally without pain or a limp.

Diagnosis

In addition to a complete medical history and physical examination, diagnostic procedures for Osgood-Schlatter disease may include:

• x-rays - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. X-rays may be performed to rule out other lesions.

Treatment

Treatment usually consists of immobilization of the leg for 6 to 8 weeks and supportive measures. Full extension immobilization of the leg through reinforced elastic knee support, plaster cast, or splint allows revascularization and reossification of the tubercle and minimizes the pull of the quadriceps.

Supportive measures include activity restrictions, aspirin and, possibly, cortisone injections into the joint to relieve tenderness. In very mild cases, simple restriction of predisposing activities (bicycling, running) may be adequate.

The goal of treatment is to control the knee pain and limit your teen's activities that could aggravate the condition. Treatment may include:

• R.I.C.E. - rest, ice, compression, and elevation
• medications (for discomfort)
• physical therapy (to help stretch and strengthen the thigh and leg muscles)

Prevention

The small injuries that may cause this disorder are usually unnoticed, so prevention may not be possible. Regular stretching, both before and after exercise and athletics, will help prevent this and other overuse injuries. Avoiding overuse -- for example, excessive running such as training for a marathon -- may be helpful.