Evaluation

evaluation

Osgood Schlatter disease (OSD) is diagnosed clinically (1).

Often patients complain of pain, tenderness and a swelling over the tibial tubercle (2).

• the pain may
  • wax and wane
  • aggravate following activities such as squatting, jumping, walking up or down stairs, or forceful contractions of the quadriceps muscle and improve with rest
  • be bilateral in 20 to 30 % of patients (1,2)

In children examination of the hip is important since some hip conditions may present with pain in the knee (e.g.- slipped capital femoral epiphysis) (3).

Local palpation and resisted knee extension will reproduce pain at the tibial tuberosity (2)

Routine radiographs are not required unless to rule out additional diagnoses such as fracture, infection, or bone tumor.

• radiographic evaluation can also be used to evaluate for avulsion injury of the apophysis or other injuries after a traumatic event
• classical findings in OSD include: an elevated tibial tubercle with soft tissue swelling, fragmentation of the apophysis, or calcification in the distal patellar tendon.
  • these can be a normal occurrence and do not always represent pathology
  • bilateral radiographic images will help in differentiating normal versus abnormal in the individual patient (1).

Reference:

• (1) Smith JM, Bhimji SS. Osgood Schlatter Disease. [Updated 2017 Oct 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018
• (2) Weiler R, Ingram M, Wolman R. 10-Minute Consultation. Osgood-Schlatter disease. BMJ. 2011;343:d4534.
• (3) Cassas KJ, Cassettari-Wayhs A. Childhood and adolescent sports-related overuse injuries. Am Fam Physician. 2006;73(6):1014-22