Osgood-Schlatter disease is a common cause of knee pain in growing adolescents. It is an inflammation of the area just below the knee where the tendon from the kneecap (patellar tendon) attaches to the shinbone (tibia).
Painful symptoms are often brought on by running, jumping, and other sports-related activities. In some cases, both knees have symptoms, although one knee may be worse than the other.
- Knee pain and tenderness at the tibial tubercle
- Swelling at the tibial tubercle
- Tight muscles in the front or back of the thigh
- Painful palpation of the tibial tuberosity.
- Pain at the tibial tuberosity that worsens with physical activity or sport.
- Increased pain at the tibial tuberosity with squating, stairs or jumping.
- In some cases increased bony protuberance at the tibial tuberosity.
Some differential diagnosis can be:
- jumper’s knee (patellar tendinitis) or Sinding- Larsen-Johanssen syndrome
- hoffa’s syndrome
- synovial plica injury
- tibial tubercule fracture.
These diseases are also localized at the patellar tendon and can cause similar knee problems.
Physical examination reveals pain during palpation of the tibial tubercle.
Resisted extension of the knee from 90° flexed position will usually reproduce pain, but resisted straight leg raised test is usually painless.
Ely’s test, which proves excessive tightness of the quadriceps femoris muscle, is positive in all cases
Treatment should begin with RICE, activity modification and sometimes nonsteroidal anti-inflammatory drugs
excercises to improve the flexibility and stenghten the surrounding musculature (quadriceps, hamstring, iliotibial bands and the gastrocnemius muscle)
stretching should initially be performed statically at a low intensity to prevent pain before progressing to dynamic or PNF stretchingStretching exercises. Stretches for the front and back of the thigh (quadriceps and hamstring muscles) may help relieve pain and prevent the disease from returning