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What Is Osgood-Schlatter Disease?

Definition

This disease on the shin bone just below the knee causes a painful, bony bump. It is an inflammation of the bone, cartilage and or tendon or tearing of the ligament within the knee and lower leg. Actually it is an overuse injury and not a disease.

Signs and symptoms

In the front of the thigh, if there is a recurrent pulling tension of the patellar tendon by large muscles then Osgood-Schlatter disease is felt.  This causes inflammation, local knee pain and swelling. An enlarged area of the tendon where it is attached to the tibia may become calcified in severe cases.  Usually both the knees are affected in this condition. The most common complaint is of knee pain that can be mild or severe. Other symptoms are:

  • Pain that increases after exercise
  • With rest the pain gets relived
  • Under the knee and over the shinbone there is swelling or tenderness
  • After exercise, the child limps
  • Surrounding the knee the muscles become tight

Causes

The quadriceps may pull on the tendon. This tendon connects the knee cap to the growth plate. This might happen when the child involves in activities such as volleyball, basketball, soccer and ballet that involves jumping, bending and running. The place where the tendon inserts into the shinbone, the tendon may pull on the growth plate due to repeated stress. This causes pain and swelling that is associated with Osgood-Schlatter disease. With a new bone growth some children’s bodies may try to close this gap. This may cause at that spot, a bony lump to develop.

Diagnosis

Based on physical examination findings and typical symptoms Osgood-Schlatter disease can be diagnosed clinically.  At the insertion of the patellar tendon, In order to document the status of calcification sometimesX0ray testing may be required.

Treatment

Usually when the bones stop growing the pain goes away that is when the teen is between the age of 14 and 18 years. Till then the treatment is needed for the symptoms. The key to pain relief is rest. Doctor may advice to limit the activities. As long as the pain is mild they can continue exercise but a short break is necessary when the symptoms flare up.  Total break and rest is required in severe cases. Some over the counter medications might help. To learn stretching and strengthening exercises after a long break physical therapy may be required. After the growth spurt if the pain is debilitating and does not subside then surgery may be required to remove the bony growth. But this happens in rare cases.

Who is affected

Usually active adolescent at the beginning of their growth spurts are struck by OSD. The period when they grow most quickly is the two year period.  At any times for girls between the ages 8 and 13 and for boys between the ages 10 and 15 the growth spurts may occur. in body it has been common but even it happens in girls participating in sports. If teens play sports such as football, volleyball, tennis, soccer, figure skating and gymnastics that involve, jumping, twisting and running then the risk increase.

Is it serious?

Commonly OSD is seen in adolescent and older children and it is one of the most common knee complain. It is basically an overuse injury and it is not as serious as it sounds. For some their activity level and involvement in sports may be restricted due to the pain.  After the growth period has slowed down the condition may improve.

Managing the disease

The stress on the knee can be reduced by shock-absorbent insoles. Before activity apply moist heat for 15 minutes or after activity apply icing for 20 minutes. This will minimize swelling. The tender shin can be protected by wrestling gel pads and basketball knee pads. Over the counter pain medications or anti inflammatory medicines may be prescribed by the doctor. Before and after activity, a good stretching program may be helpful that will focus on hamstring and quadriceps muscles.

Complications

They are uncommon but may include localized swelling or chronic pain. Just below the kneecap, on the shinbone a bony bump may develop even after the symptoms have resolved. Throughout the child’s life to some extent this bump can persist but usually with the knee function it may interfere. Osgood-Schlatter disease may cause the growth plate to be pulled away but this may happen very rarely.

Prognosis

Usually it is a self-limiting disease. After 2-3 weeks of rest the patient is able to return back but up to one year the symptoms may continue. The syndrome can be self-managed efficiently but until the growth spurt does not end it will not fully resolve.