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Osgood-Schlatter disease

Definition

Osgood-Schlatter disease is a painful swelling of the bump on the upper part of the shinbone, just below the knee. This bump is called the anterior tibial tubercle.

Alternative Names

Osteochondrosis

Causes, incidence, and risk factors

Osgood-Schlatter disease is thought to be caused by small injuries due to repeated overuse before the area has finished growing.

The quadriceps muscle is a large, strong muscle on the front part of the upper leg. When this muscle squeezes (contracts), it straightens the knee. The quadriceps muscle is an important muscle for running, jumping, and climbing.

When the quadriceps muscle is used a lot in sports activities during a child's growth spurt, this area becomes irritated or swollen and causes pain.

It is common in adolescents who play soccer, basketball, and volleyball, and who participate in gymnastics. Osgood-Schlatter disease affects more boys than girls.

Symptoms

The main symptom is painful swelling over a bump on the lower leg bone (shinbone). Symptoms occur on one or both legs.

The person may have leg pain or knee pain, which gets worse with running, jumping, and climbing stairs.

The area is tender to pressure, and swelling ranges from mild to very severe.

Signs and tests

Your doctor can tell if you have this condition by performing a physical exam.

A bone x-ray may be normal, or it may show swelling or damage to the tibial tubercle -- a bony bump below the knee. X-rays are rarely used unless the doctor wants to rule out other causes of the pain.

Treatment

Osgood-Schlatter disease will almost always goes away on its own once the child stops growing.

Treatment includes:

• Rest and decreasing activity when your child has symptoms
• Putting ice over the painful area two to four times a day, and after activities
• Ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs), or acetaminophen (Tylenol).

In many cases, the condition will get better using these methods.

Adolescents should be allowed to play sports if the activity does not cause too much discomfort. However, symptoms will improve faster if activity is kept to a minimum. Sometimes, a child will need to take a break from most or all sports for 2 or more months.

In the rare case where symptoms do not go away, a cast or brace may be used to support the leg until it heals. This typically takes 6 - 8 weeks. Crutches may be used for walking to keep weight off the painful leg.

Rarely, surgery may be needed.

Support Groups

Expectations (prognosis)

Most cases get better on their own after a few weeks or months. Most cases eventually go away once the child finished growing.

Calling your health care provider

Call your health care provider if your child has knee or leg pain, or if pain does not get better with treatment.

Prevention

The small injuries that may cause this disorder are usually unnoticed, so prevention may not be possible. Regular stretching, both before and after exercise and athletics, can help prevent injury.

References

Patel DR. Musculoskeletal injuries in sports. Prim Care. Jun 2006; 33(2): 545-79.

Cassas KJ. Childhood and adolescent sports-related overuse injuries. Am Fam Physician. Mar 2006; 73(6): 1014-22.

Mercier LR. Osgood-Schlatter disease. Ferri’s Clinical Advisor: Instant Diagnosis and Treatment. 9th ed. St. Louis, Mo: Mosby; 2009:593.