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Children who play sports that require a lot of running and jumping - such as soccer, basketball and athletics - are particularly prone to Osgood-Schlatter disease. In most cases, rest, modification of training and stretching exercises, as well as available over-the-counter medications will alleviate the pain and allow a return to daily activities.
Causes of Osgood-Schlatter disease
Typically, Osgood-Schlatter disease, often referred to as sterile necrosis of the tibia, develops in young people between the ages of 8 and 15 (usually slightly faster in girls than in boys) who lead athletic lifestyles and go through a period of rapid growth. During this time, some tendons and muscles, this includes the quadriceps muscle of the thigh, grow rapidly and not always at the same rate. Children's bones, near their ends, have an area called the growth plate. It is in this area that the bone grows in length, and as the child matures, the growth plates overgrow and form mature bone. In some places, the growth plates overlap with the attachment sites of ligaments and tendons that connect muscles to bones. The same is true of the tibial tuberosity, to which a very strong group of muscles, including the quadriceps of the thigh, which constitute the knee's upright apparatus, attach through the patella ligament and the patella. Such repeated traction behind the delicate and highly vulnerable tibial tuberosity leads to local inflammation in the area of the patellar ligament attachment.
Osgood-Schlatter disease - how to recognize the symptoms?
Typical symptoms of Osgood-Schlatter disease include pain in the tibial tuberosity (Patients often refer to it as pain under the knee) increasing during high-impact exercise (such as running or jumping), limping during or after exercise, local tenderness, sometimes increased warming of the skin over the swollen tibial tuberosity. The severity of the discomfort often varies from patient to patient. Some people experience minor pain in the knee joint area, while others experience prolonged pain that makes it difficult to perform any physical activity. Such discomfort usually occurs periodically and can last from a few weeks to as long as two years.
How is Osgood-Schlatter disease diagnosed?
The diagnosis of Osgood-Schlatter disease should be made by an orthopedic doctor based on a history and physical examination. The doctor checks the child's knee for limitation of movement, local swelling, pain, and possibly redness in the tibial tuberosity. Usually this already provides the doctor with enough information to make a proper diagnosis of whether it is Osgood-Schlatter disease. It is also worth performing an X-ray of the knee to rule out other potential causes of the aforementioned discomfort.
How is Osgood-Schlatter disease treated?
Treatment of Osgood-Schlatter disease is focused on temporarily reducing the patient's pain and implementing preventive measures to reduce the risk of recurrence. Typically, limiting physical activity should be enough to minimize the tibial and patellar ligament discomfort experienced by the child. In some patients, such a break from physical activity can last up to several months. In addition, topical measures should be implemented to reduce swelling and pain. For this purpose, ice packs and gels with an anti-inflammatory drug are recommended. In patients who have Osgood-Schlatter disease with a more severe course, the doctor may also recommend taking anti-inflammatory drugs orally. Once the initial discomfort subsides, further treatment is supported by rehabilitation of the knee joint. The basis is stretching and strengthening exercises for the thigh muscles. Manual therapy is usually helpful. In most patients, Osgood-Schlatter disease is intermittent, and complaints may recur. Symptoms should disappear completely when the child completes growth, i.e. at about age 14 for girls and 16 for boys. Osgood-Schlatter disease usually does not cause any long-term consequences. Once the disease has subsided, a return to normal training loads is possible.
Related articles:
Other possible cases of pediatric orthopedics.
Bibliography:
- National Library of Medicine - Osgood Schlatter Disease - James M. Smith; Matthew Varacallo.
- Healthline - Osgood-Schlatter Disease - Medically reviewed by William Morrison, M.D. — By Jaime Herndon, MS, MPH, MFA — Updated on August 14, 2018
- Ortho Bullets - Osgood Schlatter's Disease (Tibial Tubercle Apophysitis) - Colin Woon MD - 2021
