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Osgood-Schlatter Disease

Osgood-Schlatter disease facts

What is Osgood-Schlatter disease?

Osgood-Schlatter disease is a disorder involving painful inflammation where the patellar tendon attaches from the lower portion of the kneecap (patella) to the shinbone (tibia). Osgood-Schlatter disease is a condition of the growing child and is predominantly seen in young adolescent boys who are involved in running or jumping sports. As more girls are participating in such athletic events, they also are appearing at their doctor's office with these same complaints. A common age of occurrence is between 10-15 years of age.

What are Osgood-Schlatter disease causes and risk factors?

It is felt that stress on the tibia by the patellar tendon tugging on its attachment site during activities involving the quadriceps muscle group (the large muscles of the thigh) predisposes one to the development of Osgood-Schlatter disease. Therefore, jumping activities and prolonged running are risk factors for developing Osgood-Schlatter disease.

What are symptoms of Osgood-Schlatter disease?

Osgood-Schlatter disease is felt to be due to recurrent pulling tension of the patellar tendon by the large muscles (quadriceps) of the front of the thigh. The irritation of this pulling can cause local knee pain, inflammation, swelling, and in severe cases, an enlarged area of calcification of the tendon where it attaches to the tibia. The condition often affects both knees.

What specialists treat Osgood-Schlatter disease?

Osgood-Schlatter disease can be managed by primary-care providers, including pediatricians, family practitioners, and generalists, as well as orthopedists and sports-medicine physicians.

How do health-care professionals diagnose Osgood-Schlatter disease?

Osgood-Schlatter disease can be diagnosed clinically based on the typical symptoms and physical examination findings. X-ray testing is sometimes performed in order to document the status of the calcification at the insertion of patellar tendon. Sometimes a tiny piece of the growth area of the tibial attachment is actually pulled away from the tibia by the inflamed tendon.

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What is the treatment and outlook for Osgood-Schlatter disease?

Patients with Osgood-Schlatter disease can be helped by anti-inflammatory and pain-relieving medications (for example, ibuprofen [Advil]), icing of the area, activity modification, and rest. Many athletes find that stretching the quadriceps and hamstring is also helpful. Osgood-Schlatter disease typically goes away over time (months to years after the normal bone growth stops). Some adults who had Osgood-Schlatter disease during adolescence are left with a "knobby" appearance at the previously involved patellar tendon tibial attachment site. In rare cases, if a bone fragment in this area continues to cause pain in adulthood, it may require surgical removal.

Are there home remedies for Osgood-Schlatter disease?

Fundamental home remedies for Osgood-Schlatter disease include rest, ice and cold pack application, compression, and elevating the inflamed extremity (RICE treatment). A daily stretching routine involving the quadriceps and hamstring muscles is also helpful.

Is it possible to prevent Osgood-Schlatter disease?

Yes, it's possible to prevent Osgood-Schlatter disease by limiting stress activities involving the knees. Such sports would include basketball, volleyball, ballet, gymnastics, and high jump. All of these sports require sudden explosive activation of the quadriceps muscles. A proper stretching routine involving the quadriceps and hamstring muscle groups may be helpful to arrest the onset of Osgood-Schlatter disease.

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References
Firestein, Gary S., et al. Kelley's Textbook of Rheumatology, 9th Edition. Philadelphia, PA: Saunders, 2013.

Sullivan, J.A., and S.J. Anderson, eds. Care of the Young Athlete. Elk Grove Village, IL: American Academy of Pediatrics and American Academy of Orthopaedic Surgeons, 2000: 389.
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