Osgood-Schlatter disease (tibial tuberosity avulsion)
- Andrew J Kienstra, MD
Andrew J Kienstra, MD
- Clinical Assistant Professor of Pediatric Emergency Medicine
- University of Texas Southwestern – Austin
- Dell Children’s Medical Center
- Charles G Macias, MD, MPH
Charles G Macias, MD, MPH
- Associate Professor of Pediatrics
- Baylor College of Medicine
- Section Editors
- William Phillips, MD
William Phillips, MD
- Section Editor — Pediatric Orthopedics
- Professor of Pediatrics and Orthopedics
- Baylor College of Medicine
- Jonathan I Singer, MD
Jonathan I Singer, MD
- Section Editor — Pediatric Surgical Emergencies
- Professor of Emergency Medicine and Pediatrics
- Wright State University Boonshoft School of Medicine
Osgood-Schlatter disease, also known as osteochondritis of the tibial tubercle, was first described in 1903 [1,2]. It is a traction apophysitis of the proximal tibial tubercle at the insertion of the patellar tendon.
The clinical features and management of Osgood-Schlatter disease will be discussed here. Causes of knee pain and the general approach to the diagnosis of knee pain in children and adolescents are discussed separately. (See "Approach to acute knee pain and injury in children and skeletally immature adolescents" and "Approach to the child or adolescent athlete with chronic knee pain or injury".)
Osgood-Schlatter disease is characterized by pain and swelling at the tibial tubercle, the point of insertion of the patellar tendon (figure 1 and picture 1). The patellar tendon arises from the inferior pole of the patella, a sesamoid bone within the quadriceps tendon. The quadriceps muscle is involved in knee extension.
Osgood-Schlatter disease generally occurs in children 9 to 14 years of age who have undergone a rapid growth spurt. It occurs in approximately 20 percent of adolescents who are active in sports compared with 5 percent of nonathletes . It is bilateral in 25 to 50 percent of cases, although the involvement is typically asymmetric [3-5].
Osgood-Schlatter has traditionally occurred most commonly in boys. However, it is becoming more common in girls as their sports participation increases . Osgood-Schlatter typically occurs one to two years earlier in girls than in boys, corresponding to the different timing of the pubertal growth spurt. (See "Normal puberty", section on 'Growth spurt'.)
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- Risk factors
- CLINICAL PRESENTATION
- DIAGNOSTIC EVALUATION
- DIFFERENTIAL DIAGNOSIS
- Nonsurgical treatment
- - Pain control
- - Activity continuation
- - Physical therapy
- - Education
- - Follow-up
- Surgical treatment
- COMPLICATIONS AND SEQUELAE
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS