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Introduction

Knee Pain

Osgood-Schlatter Disease

Osgood-Schlatter disease is a common cause of knee pain in growing adolescents. It is an inflammation of the tibial tubercle, the bony bump just below the knee where the tendon from the kneecap (patellar tendon) attaches to the shinbone (tibia).

The bones of children and adolescents possess a special area where the bone is growing called the growth plate. Growth plates are areas of cartilage located near the ends of bones. When a child is fully grown, the growth plates harden into solid bone.

The tibial tubercle covers the growth plate at the end of the tibia. The group of muscles in the front of the thigh (quadriceps) attaches to the tibial tubercle.

When a child is active, the quadriceps muscles pull on the patellar tendon which, in turn, pulls on the tibial tubercle. In some children, this repetitive traction on the tubercle leads to inflammation of the growth plate. The prominence, or bump, of the tibial tubercle may become very pronounced.

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Causes

Growth spurts. Osgood-Schlatter disease most often occurs during growth spurts, when bones, muscles, tendons, and other structures are changing rapidly.

Jumping and running sports. Young athletes are at higher risk of developing Osgood-Schlatter disease because movements that cause repeated extension of the leg—especially squatting, bending or running uphill—put additional stress on the knee. This can lead to tenderness at the point where the patellar tendon attaches to the top of the tibia.

Symptoms
  • Knee pain and tenderness at the tibial tubercle

  • Swelling at the tibial tubercle

  • Tight muscles in the front or back of the thigh

  • Symptoms worsen when running, jumping, or doing other sports-related activities

Diagnosis

During the appointment, your child's doctor will discuss your child's symptoms and general health. They will conduct a thorough examination of the knee to determine the cause of the pain. This will include applying pressure to the tibial tubercle, which should be tender or painful for a child with Osgood-Schlatter disease. In addition, the doctor may also ask your child to walk, run, jump, or kneel to see if the movements bring on painful symptoms.

 

Your child's doctor may also order an X-ray image of your child's knee to help confirm the diagnosis or rule out any other problems.

Non-surgical treatments

Treatment for Osgood-Schlatter disease focuses on reducing pain and swelling. This typically requires limiting exercise activity until your child can enjoy activity without discomfort or significant pain afterwards.

 

In some cases, rest from activity is required for several months, followed by a strength conditioning program. However, if your child does not have a large amount of pain or a limp, it may be safe for them to continue participating in sports.

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Your child's doctor may recommend additional treatment methods, including:

  • Using the RICE (rest, ice, compression, elevation) method: The RICE method involves resting your knee, icing your knee, wearing an elastic bandage around your knee (compression) and elevating your knee while you’re resting. This helps to reduce pain and swelling.

  • Taking pain relievers: Your healthcare provider may recommend taking pain relievers (non-steroidal anti-inflammatory medications, or NSAIDs) to help reduce pain and swelling in your knee. Acetaminophen can be used as an alternative if you cannot tolerate NSAIDs or are allergic.

  • Stretching exercises: Stretches for the front and back of the thigh (quadriceps and hamstring muscles) may help relieve pain and prevent the disease from returning.

Surgery