Osgood-Schlatter Disease (Youth Knee Pain)

Osgood-Schlatter Disease (Youth Knee Pain)
Osgood-Schlatter Disease
(Knee pain below knee joint)

* condition that causes pain and swelling below the knee joint, where the patellar tendon attaches to the top of the shinbone (tibia), a spot called the tibial tuberosity.
*Common cause of knee pain in CHILDREN/GROWING ADOLESCENTS.
*It is a traction apophysitis at the skeletally immature tibial tubercle due to repetitive strain on the secondary ossification center of the tibial tuberosity.
*It can lead to inflammation of the patellar tendon at the tibial tuberosity, resulting in pain and swelling just below the knee.
*Traction apophysitis occurs when repeated excessive load pulls on the tendon insertion causing partial avulsions of the apophysis and inflammation

 Develops between 9-15 Y/O
  • The tibial tubercle consists of cartilaginous tissue in girls < 11 y/o and in
    boys <13 y/o.
    The unossified tibial tuberosity is more susceptible to injury.
  • Repetitive strong Quadriceps contraction
  • Patellar tendon excessively strained
  • Repeated traction apophysitis on the anterior portion of the developing can cause the ossification center to crack
    • This can result in callus formation during healing. 
    • The affected area may become fibrous, creating a separate persistent ossicle, or may show complete bony union with some enlargement of the tibial tuberosity.
    • Avulsion fracture of tibial tuberosity may also occur
Risk factors
  • Age: female (11-13 years old) & male (12-15 years)
  • OSD was originally reported to occur more in male compared to female. However, recent studies have shown that there is no significant difference in the prevalence of OSD between males & females.
  • The incidence is higher in athletes than non-athletes (21& to 4.5%) 
  • Rapid skeletal growth 
  • Training program
  • Lower extremity flexibility 
  • reduced core stability 
  • BMI
Clinical presentation
  • Complains of pain in the tibial tubercle or patellar region after physical activities
  •  Palpable & painful lump below the knee 
  • Pain worsens with physical activities
  • Tightness of the Quadriceps
Diagnostic procedure
  • The diagnosis is based on typical clinical findings (see clinical presentation). 
  • Radiographic examinations of both knees to rule out the possibility of tumors, fractures, ruptures or infections. 
  • Sonographic examination can also be used: cartilage and bony surface, the patellar tendon, soft-tissue swelling anterior to the tibial tuberosity, and fragmentation of the tibial tuberosity.
Physiotherapy management
  • Stretching exercise
  • Strengthening exercise
  • Patient education

11 Sep 2021