Osgood-Schlatter Disease

What Is It?

Osgood-Schlatter disease is a common, temporary condition that causes knee pain in older children and teenagers, especially those who play sports.

During activities that include a lot of jumping and bending — hockey, basketball, volleyball, soccer, skating, gymnastics, ballet — the quadriceps muscle (thigh muscle) pulls tightly against the kneecap and the kneecap's anchor, the patellar tendon. The fibers of the patellar tendon are attached to the shinbone (tibia). With repeated pulling against these fiber connections, the tendon can become inflamed at or near its bone attachment. The result is pain and swelling at the tibial tuberosity, a raised area at the top of the shinbone, where the patellar tendon attaches to the bone.

This connection between the tendon and tibia is particularly vulnerable to stress and injury during times when the bone is growing rapidly. For this reason, symptoms of Osgood-Schlatter disease usually appear during the teenage growth spurt. In girls, this growth spurt typically occurs between the ages of 10 and 16. In boys, it occurs a little later, between the ages of 11 and 18. Up to 20 percent of adolescent athletes experience Osgood-Schlatter disease. The problem is more common in boys.

In most cases, symptoms of Osgood-Schlatter disease develop gradually as a result of repeated stress on the patellar tendon. Less often, the condition is caused by a single trauma to the knee.

Symptoms

Symptoms of Osgood-Schlatter disease include:

• Pain, tenderness and swelling of the soft tissues at the top of the shin bone, just below the kneecap
• Redness and warmth below the kneecap
• A bony bump at the top of the shinbone

The pain from Osgood-Schlatter disease can be a mild pain that lasts only while playing sports, or it can be a constant pain that severely limits regular participation in athletic activities. Pain can occur during stair climbing, kneeling, squatting or kicking. Pain usually appears in only one knee, although in about 20 percent to 30 percent of cases, both knees are affected.

Diagnosis

Your doctor may suspect that you have Osgood-Schlatter disease because of your age, your knee symptoms and, in many cases, your sports history. To confirm the diagnosis, your doctor will examine your knee to look for pain, tenderness, swelling, and redness and to check the range of movement that you have in your joint. He or she also will check the range of motion of your hip.

If the diagnosis is not obvious, your doctor may order knee X-rays. These X-rays might show tiny bone fragments that have separated from the top of your shinbone or abnormal areas of calcium deposits in the patellar tendon. If your pain is constant, or your knee tenderness is not confined to one spot, your doctor also may use these X-rays to rule out other problems, such as a fracture, tumor or infection.