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Osgood-Schlatter Disease

(Osgood-Schlatter's Disease)

By Frank Pessler, MD, PhD, Helmholtz Centre for Infection Research;Hannover Medical School, Braunschweig, Germany;Hannover, Germany

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Osgood-Schlatter disease is osteochondrosis of the tibial tubercle.

Osteochondroses are noninflammatory, noninfectious derangements of bony growth at various ossification centers.

Osgood-Schlatter disease occurs between ages 10 yr and 15 yr and is usually unilateral. Although the disease is more common among boys, this status is changing as girls become more active in sports programs.

Etiology of Osgood-Schlatter disease is thought to be trauma due to excessive traction by the patellar tendon on its immature epiphyseal insertion, leading to microavulsion fractures.

Characteristic symptoms of Osgood-Schlatter disease are pain, swelling, and tenderness over the tibial tubercle at the patellar tendon insertion. There is no systemic disturbance.

Diagnosis

  • Clinical evaluation

  • Sometimes x-rays

Diagnosis of Osgood-Schlatter disease is by characteristic findings isolated over the tibial tubercle on examination.

Lateral knee x-rays may show fragmentation of the tibial tubercle. However, x-rays are not needed unless other disorders (eg, injury, joint inflammation) are suggested by pain and swelling extending beyond the area over the tibial tubercle or pain is accompanied by redness and warmth.

Treatment

  • Analgesics

  • Rest

  • Rarely immobilization, corticosteroid injection, and surgery

Resolution is usually spontaneous within weeks or months. Usually, taking analgesics and avoiding excessive exercise, especially deep knee bending, are the only necessary measures. Complete avoidance of sports is unnecessary.

Rarely, immobilization in plaster, intralesional injection of hydrocortisone, surgical removal of loose bodies (eg, ossicles, avulsed fragments of bone), drilling, and grafting are required.