Osgood-Schlatter Disease: Knee Pain in Adolescents

What is Osgood-Schlatter disease and how serious is the condition?

When a disease with a name is diagnosed, it is easy to become anxious, particularly if you’ve never heard the name before and don’t know how serious the condition may be. This is especially true when your child is the one being diagnosed. Osgood-Schlatter disease, which causes pain in the knee, is actually quite common and not terribly worrisome. When your child experiences ongoing pain of any kind, however, a visit to the doctor is in order. When the pain is in a bone or joint, you should make an appointment with an experienced orthopedist who will be able to diagnose and treat the problem.

Symptoms of Osgood-Schlatter Disease

The symptoms of Osgood-Schlatter disease typically show up in adolescence, particularly during growth spurts. These symptoms include knee pain and an inflammation just below the knee where the tendon from the kneecap attaches to the shin bone. This inflammation is evident as a protrusion in which the pain is focused. The adolescent may also be bothered by tight muscles in the front or back of the thigh. Symptoms often occur bilaterally, but may be worse on one side than the other. Some patients develop a temporary limp.

Reasons for Osgood-Schlatter Disease

The reasons the disorder occurs in growing adolescents is that they are experiencing growth spurts, times when bones, muscles, tendons, and other body parts are changing rapidly. Children who participate in sports, especially those involving running and jumping, are at increased risk of developing the problem. Nonetheless, less active adolescents are not immune to the disease.

During the growing years, children and adolescents have special regions called growth plates, areas of cartilage near the ends of the bones. Once the adolescent is full-grown, the growth plates have hardened into solid bone. Some growth plates, like the one at the end of the tibia, serve as junctures for tendons, the tissues that connect muscles to bones. The bony bump that covers the growth plate at the end of the tibia is called the tibial tubercle. This is the place where the muscles at the front of the thigh, the quadriceps, attach to the tibia.

During activity, the quadriceps pull on the patellar tendon which then pulls on the tibial tubercle. In some youngsters, this repeated pull on the tubercle leads to inflammation of the growth plate. The bump resulting from this inflammation may become the characteristic protrusion of Osgood Schlatter.

Diagnosis of Osgood-Schlatter Disease

The condition is diagnosed by physical examination of the knee. By applying pressure to the tibial tubercle and observing the child engaged in physical activities like walking, jumping, or kneeling, the doctor will assess precisely how the pain manifests itself. Even if the doctor is pretty well convinced that the problem is Osgood-Schlatter disease because of the tenderness at the inflamed protuberance, he or she may order X-rays or other tests to rule out other possible disorders.

Treatment of Osgood-Schlatter Disease

In the majority of cases, symptoms of Osgood-Schlatter disease can be relieved by simple remedies, such as:

  • Rest
  • Over-the-counter non-steroidal anti-inflammatory medications (NSAIDs)
  • Stretching and strengthening exercises for the quadriceps and hamstrings

Depending on the severity of the pain, the patientmay have to refrain from sports activities for several months and then participate in a strength-conditioning program before returning to his or her normal routine. It is possible, however, that the patient will not have much pain and may not have to interrupt his or her sports routine.

Positive Outcome

Most adolescents’ symptoms of Osgood-Schlatter disappear once the growth spurt is over, usually at age 14 for girls and age 16 for boys. Surgery is very rarely recommended for this condition.

nd an X-ray to determine the type and severity of the curve.

Treatment for Scoliosis

In most cases, adolescents diagnosed with idiopathic scoliosis are monitored, checked every 4 to 6 months by physical exam and X-ray to see whether the scoliosis is worsening. Treatments for scoliosis include:

  • Braces for children or adolescents who have a spinal curve of 25 to 40 degrees and who are expected to grow for at least 2 more years. Though the purpose of the bracing is to keep the curve from progressing, it will not permanently correct the correction.
  • Surgery for adolescents with curves of 40 to 50 degrees. During this procedure, metallic implants are inserted to correct some of the curvature. These implants are designed to hold the spine in the correct position until a bone graft, placed at the time of surgery, solidifies a rigid region of the curve. This process is known asspinal fusion.
  • Surgery for young children, whose spines can’t be fused because their bones still need to grow, uses a different method. In such cases, braces must always be worn after surgery.

Modern surgery for scoliosis is far superior to earlier methods because it is much more natural than previous methods. Research has shown that teenagers who have undergone spinal surgery for scoliosis are still functioning well a decade after the procedure. The fear many doctors had that there would be increased stress on the fused portion of the spine has proved to be unfounded. Even so, spinal surgery will not make the spine completely straight.

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