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Osgood-schlatter Disease

Osgood-Schlatter disease is a condition characterized by swelling of the bump (anterior tibial tubercle) present on the upper part of the tibia, below the knee. It is the most common cause of knee pain in young athletes. Osgood-Schlatter disease affects children participating in sports activities such as football, gymnastics, basketball, and sprinting. Any sporting activity creates stress over the growth plate, at the top of tibia. A growth plate is a layer of cartilage present at the end of bone which is responsible for bone growth. It affects girls in the age group of 10 to 11 years and boys in 13 to 14 years age group and generally resolves with age.

Causes
Osgood Schlatter disease is an overuse injury of the knee where one or both the knees can be affected. It is caused due to repeated use of a body part, before it has completed its growth.

Quadriceps is the large and strong muscles of the leg which is required for running, jumping, and climbing stairs. It is attached to the patellar tendon, in the knee. During the growth spurt, the overuse of quadriceps muscle can lead to inflammation of the muscle resulting in pain and swelling.

Symptoms
The most commonly symptoms of Osgood Schlatter disease include painful swelling in the lower leg, which aggravates on jumping, running, climbing stairs. Tenderness below the knee cap and stiffness of surrounding the knee muscles (quadriceps and hamstring) can also be seen.

Complications
The possible complications of Osgood Schlatter disease include:

  • Nonunion of the tibial tubercle
  • Tear of the patellar tendon
  • Chondromalacia (softening of the tissue under the knee cap)
  • Patellofemoral degenerative arthritis (inflammation of the patella in the knee and femur bone of the leg)
  • Chronic pain: If the child continues to play with pain, the condition may get worse and becomes difficult for the doctor to treat.

In very rare cases, a painful growth may develop below the knee which can be removed surgically.

Diagnosis
Diagnosis of this condition comprises of a detailed medical history and a physical examination. An X-ray of the knee is taken to check for any damage of the tibia tubercle and also rule out other causes of pain. Other diagnostic tests such as CT, MRI, and ultrasonography can also be conducted in a few patients.

Treatment Options
The treatment of a child with Osgood Schlatter disease includes:

  • RICE therapy (rest, ice, compression and elevation)
    • Rest (R): Your child needs adequate rest to ensure proper healing of the injury. Weight bearing exercises should be avoided.
    • Ice (I): Applying ice on the knee will reduce pain and inflammation. It can be applied three times a day on the knee.
    • Compression (C): Compression of the knee with an elastic bandage helps to keep the muscles intact and relieves pain.
    • Elevation (E): Your child’s leg should be elevated to reduce the inflammation.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and acetaminophen can be prescribed to reduce pain and swelling.
  • In some cases, a cast or brace may be recommended to immobilize the leg. Crutches may be used to help your child walk without putting weight on the affected leg.

The symptoms usually resolve by the age of 15 to 16 years.

Prevention:
Osgood Schlatter’s Disease is unavoidable during sports activities. However, your doctor may advise regular stretching or strengthening exercises to your child. These exercises will strengthen the quadriceps muscles.

Following sports safety guidelines can minimize the impact of Osgood Schlatter’s Disease:

  • Use of safety sports gear to protect body during sports activities.
  • Your child’s sports programs should be supervised by a trained coach.
  • Warm up exercises should be done15-30 minutes before the start of any exercises or sports activity.
  • Injured children should never be encouraged to play through pain.

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