Osteochondrosis

Alternative names
Osgood-Schlatter disease

Definition
Osgood-Schlatter disease is a painful swelling of the bump on the front of the upper tibia (lower leg bone) in an area called the anterior tibial tubercle.

Causes, incidence, and risk factors

This disease is probably caused by microtrauma (small, usually unnoticed injuries caused by repetitive overuse) which occurs before the complete maturity of the anterior tibial tubercle attachment.

The disorder is typified by a painful swelling just below the knee on the front (anterior) surface of the lower leg bone. The area is tender to pressure, and swelling ranges from minimal to very severe. Running, jumping, and climbing stairs cause discomfort. Symptoms occur on one or both legs. The disorder is seen most often in active, athletic adolescents, with boys more frequently affected than girls.

Symptoms

     
  • leg pain or Knee pain       o in one or both knees       o worse with activity, especially running, jumping, or climbing       o worse when pressure is applied to the area  
  • tenderness below the knee, worse when pressure is applied  
  • swelling of the bump on the front of the leg just below the kneecap (anterior tibial tubercle)

Signs and tests

A doctor can make a diagnosis during a physical examination. A bone X-ray may be normal, may show soft tissue swelling, or may demonstrate fragmentation of the the tibial tubercle.

Treatment

Initial treatment includes rest, ice, and nonsteroidal anti-inflammatory medication (NSAIDS, for example ibuprofen). In many cases, the condition will disappear with rest, pain medication, and the reduction of sports or exercise.

In the rare case where symptoms do not resolve, the affected leg may be immobilized by a cast or brace until healing takes place. This typically takes 6 to 8 weeks. Crutches can be used for walking to keep weight off the affected leg.

Rarely, surgery may be needed if the initial treatment fails.

Expectations (prognosis)

Most cases resolve spontaneously in weeks or several months. Adolescents should be allowed to participate in sports to the limit of their ability and comfort. However, the disorder will resolve faster if activity is kept to a minimum. Some cases may come and go, but most eventually resolve when the child finishes growing.

Complications

Chronic pain is the most significant complication.

Calling your health care provider

Call for an appointment with your health care provider if you have symptoms of this disorder.

Call for an appointment with your health care provider if Osgood-Schlatter disease fails to respond to conservative 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, will help prevent this and other overuse injuries. Avoiding overuse (for example, excessive running such as training for a marathon) may be helpful.

Johns Hopkins patient information

Last revised: December 7, 2012
by Sharon M. Smith, M.D.

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