• Knowledgebase: Information on Specific Illnesses

    Here you will find discussions of specific illnesses and their management.

    48. Osgood-Schlatter disease - Top

    Definition
    A painful swelling of the bump on the front of the tibia (anterior tibial tubercle).

    Causes, Incidence and Risk Factors
    The disease probably results from microtrauma (small, usually unnoticed injuries caused by repetitive overuse) before the complete maturity of the anterior tibial tubercle attachment.
    The disorder is typified by a painful swelling just below the knee on the front (anterior) surface of the lower leg bone (tibia). The area is tender to pressure and swelling may be minimal to very marked. Running, jumping, and climbing stairs cause discomfort. Symptoms occur on one or both legs. The disorder is seen most often in active, athletic adolescents, boys being more often affected than girls.


    Symptoms
    leg pain or knee pain
    in one or both knees
    worse with activity, especially running, jumping, or climbing
    worse when pressure is applied to the area
    tenderness below the knee, worse when pressure is applied
    swelling of the bump on the front of the leg just below the kneecap (anterior tibial tubercle)
    Signs And Tests
    Physical examination will confirm the diagnosis.
    Bone X-ray may be normal or may show soft tissue swelling, thickened ligament, and possibly free bone particles near the anterior tubercle.


    Treatment
    Initial treatment includes rest, ice, and nonsteroidal anti-inflammatory medication (NSAIDS). In many cases, the condition will disappear with rest, pain medication, and the reduction of sports or exercise.
    In the rare case where symptoms do not resolve, the affected leg may be immobilized by a cast or brace until the healing takes place, which typically takes 6 to 8 weeks. Crutches can be used for walking to keep weight off the affected leg.
    Rarely, surgery may be needed if conservative treatment fails.

    Expectations (Prognosis)
    Most cases resolve spontaneously in weeks or several months. Adolescents should be allowed to participate in sports to the limit of their ability and comfort. However, deceased activity speeds the resolution of the disorder.

    - Updated: March 5, 2001

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    • James L Horwitz, MD

    David C. Thomas, MD

    Barbara Lindberg, PNP