Osgood Schlatter Disease
Osgood Schlatter Disease (OSD)
Osgood Schlatter disease (OSD) involves the tibial tuberosity in growing children. The condition is characterised by local pain, swelling and tenderness of the tuberosity.
Pathology
OSD is thought to be caused by repetitive strain and chronic avulsion of the secondary ossification centre of the tibial tuberosity, i.e., by small injuries due to repeated overuse before the area has finished growing. The repetitive strain is from the strong pull of the quadriceps muscle produced during sporting activities, particularly during running, jumping and climbing. Accordingly, OSD is common in adolescents who play football, basketball and volleyball, and who participate in gymnastics. The tibial tuberosity avulsion continues to grow, ossify and enlarge. The intervening area may become fibrous, creating a localised non-union, or may show complete bony union with mild enlargement of the tibial tuberosity. The result is a traction apophysitis of the tibial tubercle.
DIAGNOSIS AND TREATMENT
Diagnosis is based on the clinical features of the disease and on diagnostic imaging such as ultrasound. Particularly in unilateral cases of OSD, plain radiographs of the knee are recommended to rule out other conditions such as acute tibial apophyseal fracture, infection, or tumour.
‘The true incidence of OSD is unknown. The predominant age is between 12 and 15 years in boys and between 8 and 12 years in girls, coinciding with periods of growth spurts. Boys are more affected than girls (approximately 3:1). In 20-30% of all cases OSM presents bilaterally.’
Patients not responding to conservative treatment for six months (approximately 10% of all patients) should then undergo radial shock wave therapy.
