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Osgood-Schlatter Disease

(Osgood-Schlatter's disease)

By David D. Sherry, MD, Professor of Pediatrics, University of Pennsylvania; Director, Clinical Rheumatology, The Children's Hospital of Philadelphia
Frank Pessler, MD, PhD, Helmholtz Centre for Infection Research, Braunschweig, Germany; Hannover Medical School, Hannover, Germany

Osgood-Schlatter disease is inflammation of the bone and cartilage at the top of the shinbone (tibia).

Osgood-Schlatter disease develops between the ages of 10 and 15 and usually affects only one leg. The disease is usually more common among boys, but this situation is changing as girls become more active in sports programs. The cause is thought to be repetitive, excessive pulling by the tendon of the kneecap (patellar tendon) on its point of attachment at the top of the shinbone. This attachment point is called the tibial tubercle.

The major symptoms are pain, swelling, and tenderness at the tibial tubercle. The pain worsens with activity and is relieved with rest. Swelling and tenderness eventually develop at the site.

Doctors base the diagnosis on an examination and the child's symptoms. X-rays of the knee may show the tibial tubercle has enlarged or has broken into fragments. However, x-rays are not needed unless other disorders (such as injury or joint inflammation) are suggested by pain and swelling that extend beyond the area over the tibial tubercle or pain is accompanied by redness and warmth.

Symptoms usually resolve after several weeks or months. Avoiding excessive exercise and deep knee bending helps reduce pain. However, doctors do allow children with Osgood-Schlatter disease to continue to participate in sports or exercise even when they are in pain. Use of nonsteroidal anti-inflammatory drugs (NSAIDs), stretching exercises, and application of ice on the affected knee may help relieve the pain. Rarely, the leg may need to be immobilized in plaster, a corticosteroid may need to be injected below the skin, or surgical procedures that involve the removal of fragments of bone, drilling, and grafting may be required.