Overview
Osgood-Schlatter disease (OSD) describes inflammation of the patellar ligament at its site of insertion (apophysis) of the tibial tuberosity.
It occurs due to repeated strain on the patellar tendon which leads to a pulling force on the apophysis, causing inflammation.
Epidemiology
- OSD is common and affects around 1 in 10 adolescents
- As high as 1 in 5 adolescents that participate in high-impact sports (running/jumping) can be affected
Risk Factors
- Aged 8-15 years
- High-impact sports (e.g. running and jumping)
- Biomechanical risk factors (e.g. quadriceps muscle tightness)
Presentation
- Pain, tenderness, and swelling over the tibial tuberosity
- Unilateral but can be bilateral in 30% of cases
- Pain tends to fluctuate but is worse with activity
- Knee extension against resistance may exacerbate pain
OSD can be diagnosed clinically if there are no features suggesting an alternate diagnosis (e.g. symptoms suddenly occurring after trauma to the knee, constitutional symptoms, pain that persists at night, or abnormalities on a hip or knee examination)
Management
Overview
Treatment involves simple analgesia with paracetamol and/or NSAIDs and intermittent ice packs over the tibial tuberosity.
Prognosis
- Symptoms usually resolve over weeks to months
- They may persist for 1-2 years but after this point, OSD spontaneously resolves in around 90% of people
