Osgood-Schlatter disease

Osgood-Schlatter disease is a common causes of knee pain in adolescents. There is swelling and tenderness just below the knee, over the shin bone (tibia). It is more common in boys who are having a growth spurt and may affect one or both knees. It occurs typically between the ages of 8 to 13 years in girls and 10 to 15 years in boys.

The large powerful muscles in the front of the thigh (the quadriceps) are connected via the patellar (kneecap) tendons, which run through the kneecap and attach to the tibia. The tremendous forces generated when the quadriceps contract literally try to pull off the attachment of the tendons to the shin bone, causing inflammation and pain. This problem is aggravated by running, jumping or going up or down stairs.

Osgood-Schlatter disease usually goes away with time. It typically lasts 12-24 months. When the child stops growing, the pain and swelling subside - perhaps because of hormonal changes once puberty is over. Only rarely does Osgood-Schlatter disease persist beyond puberty.

Your doctor may want to examine your child and get a knee x-ray to make sure the pain isn't caused by something else, although don't be surprised if she makes the diagnosis by history and physical examination and avoids the xray. She may tell your child to cut down on time spent playing until the pain has been gone for a while - perhaps a couple of months. Your child should try to avoid any activity that requires deep knee bending, lots of running and especially jumping.

Other than taking it easy for a while, treatment is symptomatic: icing the involved areas after exercise is helpful and perhaps have the child take an anti-inflammatory like ibuprofen. The knee may be wrapped with an elastic bandage and elevated if the symptoms are particularly severe.

Really severe cases of Osgood-Schlatter disease may require leg exercise programs, crutches, or even surgery - although I personally have never seen a patient with a case of that severity.

See also Sever disease.

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