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Osgood-Schlatter Disease: Difference between revisions
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{{Condition | {{Condition | ||
|quality=Stub | |quality=Stub | ||
}} | |image=Osgood-Schlatter disease patient.jpg|caption=Prominent left tibial tuberosity in a male with OSD.}}'''Osgood-Schlatter Disease''' (OSD) also known simply as Osgood-Schlatter is an [[Apophysitis and Osteochondrosis|apophysitis]] of the tibial tuberosity at the site of [[Enthesis|attachment]] of the patellar tendon that typically occurs in adolescent males. | ||
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== Pathophysiology == | |||
Before full maturity the apophysis is more susceptible to injury. Cartilage swelling and patellar tendon thickening can occur. | |||
Ā | |||
== Epidemiology == | |||
Generally seen in active adolescents especially those involved in jumping and kicking activities. It is bilateral in 25-50% of cases. It is generally seen at a younger age in girls compared to boys. | |||
Ā | |||
== Classification == | |||
{| class="wikitable" | |||
|+OSD Classificiation of De Flaviis et al.<ref name=":0">{{Cite journal|last=De Flaviis|first=L.|last2=Nessi|first2=R.|last3=Scaglione|first3=P.|last4=Balconi|first4=G.|last5=Albisetti|first5=W.|last6=Derchi|first6=L. E.|date=1989|title=Ultrasonic diagnosis of Osgood-Schlatter and Sinding-Larsen-Johansson diseases of the knee|url=https://pubmed.ncbi.nlm.nih.gov/2665105|journal=Skeletal Radiology|volume=18|issue=3|pages=193ā197|doi=10.1007/BF00360969|issn=0364-2348|pmid=2665105}}</ref> | |||
!Classification | |||
!Description | |||
|- | |||
|Type 1: cartilage swelling alone | |||
|Hypoechoic zone superficial to the apophysis of the anterior tibial tubercle representing pretibial cartilaginous swelling with forward displacement of the subcutaneous tissues and elevation of the patellar tendon from the tibial outline on the longitudinal view | |||
|- | |||
|Type 2: cartilage swelling and bony changes | |||
|AĀ fragmented and hypoechoic ossification center in addition to the abovementioned findings | |||
|- | |||
|Type 3: associated tendonitis | |||
|Diffuse thickening of the insertion of the patellar tendon with or without vacuolation | |||
|- | |||
|Type 4: associated bursitis | |||
|Fluid collection in the retrotendineal soft tissue representing infrapatellar bursitis | |||
|} | |||
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== Differential Diagnosis == | |||
{{DDX Box|ddx-text=*[[Sinding-Larsen-Johansson Disease]] | |||
*[[Patellar Tendinopathy]] | |||
*[[Infrapatellar Bursitis]]}} | |||
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== Prognosis == | == Prognosis == | ||
One case series of 51 | The prognosis is generally reported as being good but the evidence for this claim is limited. One case series of 51 10-14 year olds with OSD found that over one third of patients still have pain at two year follow up with a median pain duration of 42 months. This was associated with lower sports related function and quality of life. <ref>{{Cite journal|last=Holden|first=Sinead|last2=Olesen|first2=Jens Lykkegaard|last3=Winiarski|first3=Lukasz M.|last4=Krommes|first4=Kasper|last5=Thorborg|first5=Kristian|last6=Hƶlmich|first6=Per|last7=Rathleff|first7=Michael Skovdal|date=2021-08|title=Is the Prognosis of Osgood-Schlatter Poorer Than Anticipated? A Prospective Cohort Study With 24-Month Follow-up|url=https://pubmed.ncbi.nlm.nih.gov/34435066|journal=Orthopaedic Journal of Sports Medicine|volume=9|issue=8|pages=23259671211022239|doi=10.1177/23259671211022239|issn=2325-9671|pmc=8381442|pmid=34435066}}</ref> | ||
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There are documented cases of adults with residual clinical symptoms and radiological findings. This is termed '''unresolved Osgood-Schlatter Disease.''' | |||
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== Treatment == | |||
There is limited data on treatment. In particular there is no evidence of the effectiveness of specific exercise programmes. Expert advice in review articles generally includes<ref name=":0" /> | |||
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* Rest (but not immobilisation) | |||
* Activity modification (preference for activities like swimming and cycling) | |||
* [[Nonsteroidal Anti-Inflammatory Drugs|NSAIDs]] | |||
* Ice | |||
* Protective knee padding | |||
* Physical therapy | |||
* Surgical treatment in rare cases | |||
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Bracing, casting, and corticosteroid injections are generally not recommended. | |||
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== Resources == | |||
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* {{Open access icon}} Systematic review by Neuhaus et al.<ref>{{Cite journal|last=Neuhaus|first=Cornelia|last2=Appenzeller-Herzog|first2=Christian|last3=Faude|first3=Oliver|date=2021-05-01|title=A systematic review on conservative treatment options for OSGOOD-Schlatter disease|url=https://www.sciencedirect.com/science/article/pii/S1466853X2100047X|journal=Physical Therapy in Sport|language=en|volume=49|pages=178ā187|doi=10.1016/j.ptsp.2021.03.002|issn=1466-853X}}</ref> | |||
Ā | |||
== References == | |||
[[Category:Knee and Leg Conditions]] | [[Category:Knee and Leg Conditions]] | ||
[[Category:Developmental Disorders]] | |||
Revision as of 12:01, 7 April 2022
This article is a stub.
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| Osgood-Schlatter Disease |
|---|
Osgood-Schlatter Disease (OSD) also known simply as Osgood-Schlatter is an apophysitis of the tibial tuberosity at the site of attachment of the patellar tendon that typically occurs in adolescent males.
Pathophysiology
Before full maturity the apophysis is more susceptible to injury. Cartilage swelling and patellar tendon thickening can occur.
Epidemiology
Generally seen in active adolescents especially those involved in jumping and kicking activities. It is bilateral in 25-50% of cases. It is generally seen at a younger age in girls compared to boys.
Classification
| Classification | Description |
|---|---|
| Type 1: cartilage swelling alone | Hypoechoic zone superficial to the apophysis of the anterior tibial tubercle representing pretibial cartilaginous swelling with forward displacement of the subcutaneous tissues and elevation of the patellar tendon from the tibial outline on the longitudinal view |
| Type 2: cartilage swelling and bony changes | A fragmented and hypoechoic ossification center in addition to the abovementioned findings |
| Type 3: associated tendonitis | Diffuse thickening of the insertion of the patellar tendon with or without vacuolation |
| Type 4: associated bursitis | Fluid collection in the retrotendineal soft tissue representing infrapatellar bursitis |
Differential Diagnosis
Differential Diagnosis
Prognosis
The prognosis is generally reported as being good but the evidence for this claim is limited. One case series of 51 10-14 year olds with OSD found that over one third of patients still have pain at two year follow up with a median pain duration of 42 months. This was associated with lower sports related function and quality of life. [2]
There are documented cases of adults with residual clinical symptoms and radiological findings. This is termed unresolved Osgood-Schlatter Disease.
Treatment
There is limited data on treatment. In particular there is no evidence of the effectiveness of specific exercise programmes. Expert advice in review articles generally includes[1]
- Rest (but not immobilisation)
- Activity modification (preference for activities like swimming and cycling)
- NSAIDs
- Ice
- Protective knee padding
- Physical therapy
- Surgical treatment in rare cases
Bracing, casting, and corticosteroid injections are generally not recommended.
Resources
Systematic review by Neuhaus et al.[3]
References
- ā 1.0 1.1 De Flaviis, L.; Nessi, R.; Scaglione, P.; Balconi, G.; Albisetti, W.; Derchi, L. E. (1989). "Ultrasonic diagnosis of Osgood-Schlatter and Sinding-Larsen-Johansson diseases of the knee". Skeletal Radiology. 18 (3): 193ā197. doi:10.1007/BF00360969. ISSN 0364-2348. PMID 2665105.
- ā Holden, Sinead; Olesen, Jens Lykkegaard; Winiarski, Lukasz M.; Krommes, Kasper; Thorborg, Kristian; Hƶlmich, Per; Rathleff, Michael Skovdal (2021-08). "Is the Prognosis of Osgood-Schlatter Poorer Than Anticipated? A Prospective Cohort Study With 24-Month Follow-up". Orthopaedic Journal of Sports Medicine. 9 (8): 23259671211022239. doi:10.1177/23259671211022239. ISSN 2325-9671. PMC 8381442. PMID 34435066. Check date values in:
|date=(help) - ā Neuhaus, Cornelia; Appenzeller-Herzog, Christian; Faude, Oliver (2021-05-01). "A systematic review on conservative treatment options for OSGOOD-Schlatter disease". Physical Therapy in Sport (in English). 49: 178ā187. doi:10.1016/j.ptsp.2021.03.002. ISSN 1466-853X.
