Osgood-Schlatter Disease (Youth Knee Pain)

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https://wa.link/5lnmnv

https://wa.link/5lnmnv

* condition that causes pain and swelling below the knee joint, where the patellar tendon attaches to the top of the shinbone (tibia), a spot called the tibial tuberosity.
*Common cause of knee pain in CHILDREN/GROWING ADOLESCENTS.
*It is a traction apophysitis at the skeletally immature tibial tubercle due to repetitive strain on the secondary ossification center of the tibial tuberosity.
*It can lead to inflammation of the patellar tendon at the tibial tuberosity, resulting in pain and swelling just below the knee.
*Traction apophysitis occurs when repeated excessive load pulls on the tendon insertion causing partial avulsions of the apophysis and inflammation

 
 Develops between 9-15 Y/O

• The tibial tubercle consists of cartilaginous tissue in girls < 11 y/o and in
  boys <13 y/o.
  The unossified tibial tuberosity is more susceptible to injury.

• Repetitive strong Quadriceps contraction
• Patellar tendon excessively strained
• Repeated traction apophysitis on the anterior portion of the developing can cause the ossification center to crack
  • This can result in callus formation during healing. 
  • The affected area may become fibrous, creating a separate persistent ossicle, or may show complete bony union with some enlargement of the tibial tuberosity.
  • Avulsion fracture of tibial tuberosity may also occur

• Age: female (11-13 years old) & male (12-15 years)
• OSD was originally reported to occur more in male compared to female. However, recent studies have shown that there is no significant difference in the prevalence of OSD between males & females.
• The incidence is higher in athletes than non-athletes (21& to 4.5%) 
• Rapid skeletal growth 
• Training program
• Lower extremity flexibility 
• reduced core stability 
• BMI

 
Clinical presentation

• Complains of pain in the tibial tubercle or patellar region after physical activities
•  Palpable & painful lump below the knee 
• Pain worsens with physical activities
• Tightness of the Quadriceps

• The diagnosis is based on typical clinical findings (see clinical presentation). 
• Radiographic examinations of both knees to rule out the possibility of tumors, fractures, ruptures or infections. 
• Sonographic examination can also be used: cartilage and bony surface, the patellar tendon, soft-tissue swelling anterior to the tibial tuberosity, and fragmentation of the tibial tuberosity.

• Stretching exercise
• Strengthening exercise
• Patient education