Osgood-Schlatter disease (OSD) is a clinical diagnosis. The individual's history and a physical examination are usually sufficient to make the diagnosis of OSD.
Anterior knee pain usually is the presenting symptom. Patients usually report that the knee pain occurs during activities such as running, jumping, squatting, and ascending or descending stairs. Pain often subsides with rest and activity modification.
Athletes involved in football, soccer, basketball, gymnastics, and ballet are most commonly affected.
Symptoms often are vague, gradual, and intermittent in onset. Symptoms may develop without trauma or other apparent cause, although approximately 50% of patients give a history of precipitating trauma. The disease is bilateral in 20-50% of patients.
The physical examination is very specific, with point tenderness over the tibial tubercle. A firm mass may be palpable.
Other physical examination findings may include the following:
Proximal tibial swelling and tenderness
Enlargement or prominence of the tibial tubercle
Reproducible and aggravated pain by direct pressure and jumping (quadriceps contraction)
Pain with resisted knee extension (quadriceps contraction)
Erythema of the tibial tuberosity
The following exam findings must be tested and confirmed to verify no concomitant or more severe injury:
Full range of motion of the knee
No effusion or meniscal signs
Negative Lachman test (no knee instability)
Normal neurovascular examination
No abnormal findings in the hip and ankle joints
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