Osgood-Schlatter disease
From Wikipedia, the free encyclopedia
| Osgood-Schlatter disease Classification and external resources |
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|---|---|
| Lateral aspect of right leg. (Tuberosity of tibia labeled at center right.) | |
| ICD-10 | M92.5 |
| ICD-9 | 732.4 |
| DiseasesDB | 9299 |
| MedlinePlus | 001258 |
| eMedicine | emerg/347 orthoped/426 radio/491 sports/89 |
Osgood-Schlatter disease (also known as tibial tubercle apophyseal traction injury) is an inflammation of the growth plate at the tibial tuberosity, and is one of a group of conditions collectively called osteochondroses. The condition is named after the American surgeon Robert Bayley Osgood (1873–1956) and the Swiss surgeon Carl Schlatter (1864–1934), who independently described the disease in 1903.[1][2][3]
The disease is most common in active boys and girls aged 11-15[4] and is usually self-limiting.
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[edit] Causes
The condition is caused by stress on the patellar tendon that attaches the quadriceps muscle at the front of the thigh to the tibial tuberosity. Following an adolescent growth spurt, repeated stress from contraction of the quadriceps is transmitted through the patellar tendon to the immature tibial tuberosity. This can cause multiple subacute avulsion fractures along with inflammation of the tendon, leading to excess bone growth in the tuberosity and producing a visible lump.
[edit] Symptoms
Pain and swelling directly over the tibial tubercle is most common. Point tenderness is noted on examination.
Pain is aggravated by loaded knee extension activity, especially activity with power or impact characteristics. Symptoms may occur with activities of daily living (ADLs) such as walking and using stairs.
The symptoms usually resolve with treatment but may recur as a new episodes until skeletal maturity, when the tibial epiphysis fuses.
[edit] Treatment
Diagnosis is made clinically,[5] and treatment is conservative with rest and simple pain reduction measures of ice packs and if required paracetamol (acetaminophen) or ibuprofen. The condition usually resolves in a few months, with a study of young athletes revealing a requirement of complete training cessation for 3 months (on average) and gradual resumption of full training by 7 months.[6]
Bracing or use of plaster of paris to enforce joint immobilization is rarely required and does not necessarily give quicker resolution.[7] Surgical excision may rarely be required in skeletally mature patients.[8]
After symptoms have resolved, a gradual progression to the desired activity level may begin. In addition, predisposing factors should be evaluated and addressed. Commonly quadriceps and/or hamstring tightness is present and should be addressed with stretching exercises. Training factors such as intensity and repetition should also be evaluated and addressed.
[edit] Additional images
 MBq Osgood-Schlatter |
[edit] References
- ^ Osgood R.B. (1903). "Lesions of the tibia tubercle occurring during adolescence". Boston Medical and Surgical Journal 148: 114-7.
- ^ Schlatter C. (1903). "Verletzungen des schnabelförmigen Forsatzes der oberen Tibiaepiphyse". [Bruns] Beiträge zur klinischen Chirurgie 38: 874-87.
- ^ Nowinski RJ, Mehlman CT (1998). "Hyphenated history: Osgood-Schlatter disease". Am J. Orthop. 27 (8): 584-5. PMID 9732084.
- ^ Yashar A, Loder RT, Hensinger RN (1995). "Determination of skeletal age in children with Osgood-Schlatter disease by using radiographs of the knee". J Pediatr Orthop 15 (3): 298-301. PMID 7790482.
- ^ Cassas KJ, Cassettari-Wayhs A (2006). "Childhood and adolescent sports-related overuse injuries". Am Fam Physician 73 (6): 1014-22. PMID 16570735.
- ^ Kujala UM, Kvist M, Heinonen O (1985). "Osgood-Schlatter's disease in adolescent athletes. Retrospective study of incidence and duration". Am J Sports Med 13 (4): 236-41. doi:. PMID 4025675.
- ^ Engel A, Windhager R (1987). "[Importance of the ossicle and therapy of Osgood-Schlatter disease]" (in German). Sportverletz Sportschaden 1 (2): 100-8. PMID 3508010.
- ^ Gholve PA, Scher DM, Khakharia S, Widmann RF, Green DW (2007). "Osgood Schlatter syndrome". Curr. Opin. Pediatr. 19 (1): 44-50. doi:. PMID 17224661.
