Osgood Schlatter disease is probably the most common cause of knee pain in active children between the ages of 9 -16 years. It is one of several conditions known as osteochodrosis which are caused by repeated overuse in the growing skeleton.
What is it?
Osgood Schlatter disease is caused by repeated pull (traction) of the patella tendon where it attaches to the upper part of the shin bone. This area (tibial tuberosity) becomes irritated or swollen and causes pain. Other examples of osteochondrosis include Sever’s Disease (heel) and Scheuermann’s disease (spine).
The condition occurs more commonly in boys than girls with a male–to-female ratio of approximately 4:1. It is postulated that this difference may be related to a higher participation in sport by boys compared to girls.
Symptoms and Diagnosis
The main symptoms are pain and swelling of the tibial tuberosity (bump on the upper shin bone) in one or both legs. Pain is often exacerbated by running, jumping and ascending or descending steps. The examining doctor will confirm this diagnosis by performing a thorough physical exam. X-rays may be normal or may show swelling or damage to the tibial tuberosity.
As with all the other osteochondrosis, Osgood Schlatter disease is self-limiting and almost always goes away once the child stops growing. Treatment is therefore conservative and aimed at symptomatic relief.
- Rest from aggravating activity
- Ice the painful area when painful and after activities
- NSAIDs (non steroidal anti inflammatories)
If pain is not severe, the child may continue with sport, however, faster resolution of symptoms has been documented when activity is stopped completely for at least one week, with graduated return to full training over 3-4 weeks. Parents should be aware that symptoms may recur for 12-24 months before complete resolution at skeletal maturity.
In rare cases where symptoms do not resolve with this treatment, a brace or cast may be used to support the leg until it heals. This may take up to 6 – 8 weeks. This does not necessarily give quicker resolution, but may help reduce pain by decreasing the strain on the patella tendon. Surgical excision is rarely needed but does yield good results in chronic cases (particularly those with bony or cartilaginous ossicles) that do not respond to conservative treatment.
Again, one must mention that this condition is self-limiting. Perhaps this is one of those conditions that the old wives tales refer to as ‘Growing Pains’? So as with all growing pains, rest assured that your child will eventually grow out of it!
Next month, the third of the osteochondroses, namely Scheuermann’s Disease.
References available on request.
Yours in Health and Fitness!