Consult the medical resource doctors trust

UpToDate is one of the most respected medical information resources in the world, used by over 360,000 doctors and thousands of patients to find answers to medical questions.

  • Content written by a faculty of over 4,000 physicians from leading medical institutions
  • Unbiased: free of advertising or pharmaceutical funding
  • Evidence-based treatment recommendations
  • Continuously updated to incorporate new medical findings

Osgood-Schlatter disease

INTRODUCTION

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 "Causes of knee pain and injury in the young athlete" and "Approach to the young athlete with acute knee pain or injury" and "Approach to the young athlete with chronic knee pain or injury".)

ANATOMY

Osgood-Schlatter disease is characterized by pain and swelling at the tibial tubercle, the point of insertion of the patellar tendon (picture 1 and picture 2). 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.

EPIDEMIOLOGY

Osgood-Schlatter disease generally occurs in children aged 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 to 5 percent of nonathletes [3]. It is bilateral in 25 to 50 percent of cases, although the involvement is typically asymmetric [3-5].

Osgood-Schlatter traditionally occurred most commonly in boys. However, it is becoming more common in girls as their sports participation increases [6]. 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 'Peak height velocity'.)
To continue reading this article you need to subscribe.

Read the rest of this article and others like it

The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use (click here) ©2010 UpToDate, Inc.
References Top
  1. Osgood, RB. Lesions of the tibial tubercle occurring during adolescence. Boston Med Surg J 1903; 148:114.
  2. Schlatter, C. Verletzungen des schnabelforminogen fortsatzes der oberen tibiaepiphyse. Beitre Klin Chir Tubing 1903; 38:874.
  3. Kujala, UM, Kvist, M, Heinonen, O. Osgood-Schlatter's disease in adolescent athletes. Retrospective study of incidence and duration. Am J Sports Med 1985; 13:236.
  4. Krause, BL, Williams, JP, Catterall, A. Natural history of Osgood-Schlatter disease. J Pediatr Orthop 1990; 10:65.
  5. Stanitski, CL. Knee overuse disorders in the pediatric and adolescent athlete. Instr Course Lect 1993; 42:483.
  6. Duri, ZA, Patel, DV, Aichroth, PM. The immature athlete. Clin Sports Med 2002; 21:461.
  7. Willis, RB. Sports medicine in the growing child. In: Lovell and Winter's Pediatric Orthopaedics, 6th ed, Morrissy, RT, Weinstein, SL (Eds), Lippincott Williams & Wilkins, Philadelphia 2006. p. 1384.
  8. Cassas, KJ, Cassettari-Wayhs, A. Childhood and adolescent sports-related overuse injuries. Am Fam Physician 2006; 73:1014.
  9. Mital, MA, Matza, RA, Cohen, J. The so-called unresolved Osgood-Schlatter lesion: a concept based on fifteen surgically treated lesions. J Bone Joint Surg Am 1980; 62:732.
  10. Gholve, PA, Scher, DM, Khakharia, S, et al. Osgood Schlatter syndrome. Curr Opin Pediatr 2007; 19:44.
  11. Ogden, JA, Southwick, WO. Osgood-Schlatter's disease and tibial tuberosity development. Clin Orthop 1976; :180.
  12. Hirano, A, Fukubayashi, T, Ishii, T, Ochiai, N. Magnetic resonance imaging of Osgood-Schlatter disease: the course of the disease. Skeletal Radiol 2002; 31:334.
  13. Rosenberg, ZS, Kawelblum, M, Cheung, YY, et al. Osgood-Schlatter lesion: fracture or tendinitis? Scintigraphic, CT, and MR imaging features. Radiology 1992; 185:853.
  14. Demirag, B, Ozturk, C, Yazici, Z, Sarisozen, B. The pathophysiology of Osgood-Schlatter disease: a magnetic resonance investigation. J Pediatr Orthop B 2004; 13:379.
  15. Aparicio, G, Abril, JC, Calvo, E, Alvarez, L. Radiologic study of patellar height in Osgood-Schlatter disease. J Pediatr Orthop 1997; 17:63.
  16. Andrisano, A, Mignani, G, Mazzetti, M. Long term results in Osgood-Schlatters disease. Ital J Orthop Traumatol 1985; 11:483.
  17. Clark, MC, Iwinski, HJ. The limping child: The challenges of an accurate assessment and diagnosis. Pediatr Emerg Med 1997; 2:123.
  18. Micheli, LJ. Osgood-Schlatter syndrome. In: The Sports Medicine Bible, HarperPerennial, New York, NY 1995. p. 137.
  19. Dunn, JF. Osgood-Schlatter disease. Am Fam Physician 1990; 41:173.
  20. MIcheli, LJ, Purcell, L. Osgood-Schlatter disease. In: The Adolescent Athlete: A Practical Approach. Springer New York, NY 2007. p. 311.
  21. Osgood-Schlatter Disease. In: Essentials of Musculoskeletal Care, 2nd ed, Greene, WB (Ed), American Academy of Orthopedic Surgeons, Rosemont, IL 2001. p.719.
  22. Staheli, LT. Sports. In: Fundamentals of Pediatric Orthopedics, 2nd ed, Lippincott Raven, Philadelphia 1998. p.111.
  23. Wall, EJ. Osgood-Schlatter disease: practical treatment for a self-limited condition. Phys Sport Med 1998; 26:29.
  24. Chow, SP, Lam, JJ, Leong, JC. Fracture of the tibial tubercle in the adolescent. J Bone Joint Surg Br 1990; 72:231.
  25. Bloom, RA, Gomori, J, Milgrom, C. Ossicles anterior to the proximal tibia. Clin Imaging 1993; 17:137.
  26. Scotti, DM, Sadhu, VK, Heimberg, F, O'Hara, AE. Osgood-Schlatter's disease, an emphasis on soft tissue changes in roentgen diagnosis. Skeletal Radiol 1979; 4:21.
  27. Schwend, RM, Geiger, J. Outpatient pediatric orthopedics. Common and important conditions. Pediatr Clin North Am 1998; 45:943.
  28. Tachdjian, MO. The knee and leg. In: Clinical Pediatric Orthopedics: The Art of Diagnosis and Principles of Management. Appleton and Lange, Stamford, CT 1997. p.107.
  29. D'Ambrosia, RD, MacDonald, GL. Pitfalls in the diagnosis of Osgood-Schlatter disease. Clin Orthop 1975; :206.
  30. Bloom, OJ, Mackler, L, Barbee, J. Clinical inquiries. What is the best treatment for Osgood-Schlatter disease?. J Fam Pract 2004; 53:153.
  31. Hussain, A, Hagroo, GA. Osgood-Schlatter disease. Sports Exer Injury 1996; 2:202.
  32. Beovich, R, Fricker, PA. Osgood-Schlatter's disease. A review of the literature and an Australian series. Aust J Sci Med Sport 1988; 20:11.
  33. Weiss, JM, Jordan, SS, Andersen, JS, et al. Surgical treatment of unresolved Osgood-Schlatter disease: ossicle resection with tibial tubercleplasty. J Pediatr Orthop 2007; 27:844.
  34. Stanitski, CL. Patellofemoral mechanism. In: DeLee & Drez's Orthopaedic Sports Medicine Principles and Practice, 2nd ed. DeLee, JC, Drez, D, Miller, MD (Eds). Saunders, Philadelphia 2003. p.1814.
  35. Rostron, PK, Calver, RF. Subcutaneous atrophy following methylprednisolone injection in Osgood-Schlatter epi-physitis. J Bone Joint Surg Am 1979; 61:627.
  36. Tolo, VT. The lower extremity. In: Lovell and Winter's Pediatric Orthopaedics, Morrisey, RT, Weinstein, SL (Eds), Lippincott-Ravin, Philadelphia 1996. p.1063.
  37. Neuschwander, DC. Peripatellar pathology. In: DeLee & Drez's Orthopaedic Sports Medicine Principles and Practice, 2nd ed. DeLee, JC, Drez, D, Miller, MD (Eds). Saunders, Philadelphia 2003. p. 1867.
  38. Orava, S, Malinen, L, Karpakka, J, et al. Results of surgical treatment of unresolved Osgood-Schlatter lesion. Ann Chir Gynaecol 2000; 89:298.
  39. Flowers, MJ, Bhadreshwar DR. Tibial tuberosity excision for symptomatic Osgood-Schlatter disease. J Pediatr Orthop 1995; 15:292.
  40. Binazzi, R, Felli, L, Vaccari, V, Borelli, P. Surgical treatment of unresolved Osgood-Schlatter lesion. Clin Orthop Relat Res 1993; :202.
  41. Pasque, CB, McGinnis, DW. Knee. In: Care of the Young Athlete. American Acadmey of Orthopedic Surgeons and American Academy of Pediatrics, Elk Grove Village, IL 2000. p.377.
  42. Wiss, DA, Schilz, JL, Zionts, L. Type III fractures of the tibial tubercle in adolescents. J Orthop Trauma 1991; 5:475.
  43. Bolesta, MJ, Fitch, RD. Tibial tubercle avulsions. J Pediatr Orthop 1986; 6:186.
  44. Lynch, MC, Walsh, HP. Tibia recurvatum as a complication of Osgood-Schlatter's disease: a report of two cases. J Pediatr Orthop 1991; 11:543.
  45. Bellicini, C, Khoury, JG. Correction of genu recurvatum secondary to Osgood-Schlatter disease: a case report. Iowa Orthop J 2006; 26:130.
white circle LOG IN
white circle DEMO