OSGOOD-SCHLATTER DISEASE
Osgood-Schlatter disease, an inflammatory condition, is a common cause of anterior knee pain in children and adolescents. It is caused by repetitive traction of the patellar tendon on the tibial tubercle ossification center or apophysis, which may cause substantial inflammation and pain. Symptomatic patients are usually between 10 and 14 years of age, and up to 30 percent of patients will have bilateral involvement.10,11 Nearly 50 percent of patients are involved in regular athletic activity.12 Pain is often exacerbated by jumping activities and direct pressure, such as kneeling. Patients have moderate to severe tenderness, swelling, and prominence over the tibial tubercle. The diagnosis is often made clinically, although plain radiographs should be obtained to rule out fractures, tumors, or osteomyelitis if the presenting signs and symptoms are atypical. Radiographs of patients with Osgood-Schlatter disease may show anterior soft tissue swelling and fragmentation of the tibial tubercle. Magnetic resonance imaging and ultrasonography are not routinely necessary.13
Osgood-Schlatter disease is a self-limited process that responds well to activity modification and acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs). Stretching and physical therapy to improve flexibility of lower-extremity muscles can help reduce symptoms. Some case series have shown that operative treatment can alleviate symptoms in patients with mature skeletons who continue to have disabling symptoms.14,15