Knee pain - Osgood Slatter Disease

Osgood Schlatter disease


background

  • Common cause knee pain - esecially adolescents
  • Painful overuse of the tibial tuberosity
  • Gradual onset
  • Max after sport, especially jumping (basketball)
  • Early Teens (growth spurts), M>>F
  • 30% bilateral
  • Repeated pull off (quads ligament) microfractures at epiphyseal plate

Examination

  • Tibial tuberosity prominnce ± tenderness
  • Pain triggered by resisted knee extension
  • Clinical Dx - no need for x-ray

Management

  • Conservative
  • Reduce (usually no need to avoid completely) triggering activity but maintain activity (change sport etc)
  • 90% will have symptom resolution by end of teens growth spurt
    • ROUGH etsimates e.g. compare with mean parental height, siblings height, menarche
  • Local ice therapy or NSAIDs PRN
  • Later physiotherapy to stretch hamstrings and iliotibial band
  • No steroids

Consider

  • Other DDx
  • Hx trauma
  • Constitutional symptoms
    • T °, ↓wt, malaise, arthralgia
    • Night pain, rest pain
  • Beware hip exam

Links

For patients

Patient UK information leaflet.

East Kent Hospitals University NHS Foundation Trust, quadriceps and hamstring stretches.

For medics

Gholve PA, Scher DM, Khakharia S, Widmann RF, et al. Osgood Schlatter syndrome. Curr Opin Pediatr 2007;19:44-50

NHS Clinical Knowledge Summaries. Osgood Schlatter’s disease.


Content by Dr Íomhar O' Sullivan 22/08/2011. Last review Dr ÍOS 16/12/19