Osgood-Schlatter Disease

Description

Osgood-Schlatter disease is a common form of pain in the adolescent knee. The pain is localized to the raised area of the shinbone (tibia) just below the knee, the tibial tubercle. The tibial tubercle is the area of the tibia where the thigh muscles attach to the shin bone. These muscles straighten (extend) the knee. The tibial tubercle has a growth plate under it which makes it weaker than other parts of the bone. If the pull of the thigh muscle on the tibial tubercle is significant enough, the growth plate can start to stretch.

Symptoms

Swelling of the tibial tubercle

Pain localized to the tibial tubercle. Most commonly the pain of the tibial tubercle occurs with activity.

Risk Factors

Diagnosis

The history and physical examination are usually sufficient to make the diagnosis. The history is usually pain localized to the tibial tubercle with activity, but it can vary in frequency and intensity. (There may be days when there is no pain and other days when the pain is severe and actually keep the sufferer from playing.) The physical exam will find varying degrees of swelling and tenderness of the tibial tubercle. There may be pain and weakness when the patient tries to straighten the knee against resistance.

An x-ray is may be helpful in determining the extent to which the growth plate has been stretched and to get a sense of how much growth is still left in the growth plate.

Treatment

The treatment is first aimed at diminishing the severity of the pain. Tylenol and/or Advil are helpful and should be taken as instructed. The dose of the medicine will be determined by the size and weight of the patient. Ice is helpful to reduce the pain and swelling. It should be use for 15-20 minutes after activity and about 3-4 times a day. Activities that cause pain should be avoided or significantly reduced. A stretching and strengthening program should be started to correct and tightness and imbalance noted in the muscles of the leg. (The stretching part of the program should never be stopped even after the symptoms resolve since the pain can come back.) As the pain decreases and the patients conditioning improves, activities can be added as long as they don’t increase the pain. Ultimately, Osgood-Schlatter disease will completely resolve when the patient is done growing. This typically happens at around age 14 for girls and 16-18 for boys.

Written by James A. Shapiro, MD