Musculoskeletal Disorders: Osteochondroses: Osgood-Schlatter

Description

Osgood-Schlatter disease is a common condition that causes knee pain in older children and teenagers, especially those who play sports.
During activities that include a lot of jumping and bending (basketball, volleyball, soccer, skating, gymnastics, ballet), the pull on an adolescent's thigh muscles can place extraordinary tension on the patellar tendon (a wide band of tissue connected to the lower border of the kneecap). This tension exerts traction on the patellar tendon, pulling it away from the shin bone. The result is pain and swelling in the tibial tuberosity (a raised area at the top of the shin bone, where the patellar tendon attaches).

Symptoms and Signs

Symptoms of Osgood-Schlatter disease usually appear during the teenage growth spurt, when bones are growing rapidly. In girls, this growth spurt typically occurs between the ages of 10 and 16 (cf. puberty ), whereas in boys, it occurs a little later, between the ages of 11 and 18. As many as 20 percent of athletes in these age groups suffer from Osgood-Schlatter disease, although the problem is slightly more common in boys.

In most cases, symptoms of Osgood-Schlatter disease develop gradually as a result of repeated stress on the patellar tendon. Less often, the condition is caused by a single trauma to the knee.

Symptoms of Osgood-Schlatter disease include:

• Pain, tenderness and swelling at the top of the shin bone, just below the kneecap.
• Redness and warmth below the kneecap.
• A painful, bony bump at the top of the shin bone, just below the kneecap.

The pain from Osgood-Schlatter disease varies. It can be a mild pain that lasts only while you are playing sports, or it can be a constant pain that severely limits regular participation in athletic activities. Pain usually appears in only one knee, although in about 20 percent to 30 percent of cases, both knees are affected.

Diagnosis and Treatment

A doctor may suspect Osgood-Schlatter disease because of the child's age, knee symptoms and (in many cases) history of playing a sport that produces jumping or bending stresses on the knee. To confirm the diagnosis, the doctor will examine your knee for pain, tenderness, swelling, redness and range of motion as well as checking the range of motion of the hip. Occasionally, the doctor may need to order knee X-rays, an ultrasound or a magnetic resonance imaging (MRI) scan to further evaluate the patellar tendon.

Osgood-Schlatter disease is a self-limited condition, which means that it eventually goes away on its own. Treatment depends on the severity of symptoms.

In mild cases, the doctor will recommend that limiting activities that cause knee pain, especially anything that includes jumping or deep knee bending. If you do too much, you can make the condition worse.
If the knee pain is constant, the doctor will probably recommend that the child stop playing sports altogether for a while. It some cases, the child may be asked to wear a cast or brace for a period of six to eight weeks, followed by rehabilitation to strengthen leg muscles.
Very rarely, if knee symptoms are persistent and severely disabling, a doctor may recommend surgery to remove bone fragments.

Osgood-Schlatter disease almost always resolves when a teenager's growth spurt ends and the bones mature, although it may leave a large permanent bump on the knee. In addition, about 60 percent of teens who have Osgood-Schlatter disease find it painful to kneel when they are adults.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. Intelihealth.com, Children's Health Section: http://www.intelihealth.com/