Osgood-Schlatter Disease

For the past 3 years, a 17-year-old boy had experienced intermittent pain in the right knee. The pain worsened when he went up and down stairs, ran, jumped, or knelt.

Tender swelling was noted over the right tibial tubercle. A radiograph of the right knee showed fragmentation and irregularity of the outline of the tibial tuberosity with soft tissue swelling.

Drs Edmond K. H. Liu and Alexander K. C. Leung of Calgary, Alberta, diagnosed Osgood-Schlatter disease, which is caused by traumatic stress from a contracted quadriceps mechanism on the proximal tibial tuberosity. The pull of the ligamentum patellae detaches bone fragments from the tibial tuberosity.

Osgood-Schlatter disease typically presents at puberty and most often affects boys. The condition is bilateral in 25% to 50% of patients. The patient usually has a history of rapid growth and active participation in sports. Generally, treatment consists of rest and avoidance of activities that involve quadriceps contraction. If necessary, NSAIDs may be used to ameliorate pain. The patient may resume normal activities when the pain disappears, which usually occurs over time, or when the pain abates and no longer interferes with normal movement.

In patients with severe disease or in those who do not respond to conservative therapy, a brace or a cast may be needed to immobilize the knee. This patient used a knee brace for 6 months; his recovery was uneventful.