Osgood-Schlatter Disease Differential Diagnoses

  • Author: J Andy Sullivan, MD; Chief Editor: Craig C Young, MD   more...
 
Updated: Dec 1, 2011
 
 

Diagnostic Considerations

The most significant medicolegal pitfall is failing to diagnose another condition that could result in long-term permanent damage (eg, tumor, osteochondritis dissecans). Most other conditions have a more concerning clinical examination or history. Therefore, always obtain radiographs and consider the possibility of a referred pain syndrome from the hip.

Conditions to be considered in the differential diagnosis of Osgood-Schlatter disease (OSD), in addition to those in the next section, include the following:

  • Sinding-Larson-Johansson syndrome
  • Tumor
  • Perthes disease
  • Quadriceps tendon avulsion
  • Chondromalacia patellae
  • Patellar tendonitis
  • Infectious apophysitis
  • Soft-tissue malignancy
  • Accessory ossification centers
  • Osteomyelitis of the proximal tibia
  • Hoffa's syndrome
  • Synovial plica injury
  • Tibial tubercle fracture

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

J Andy Sullivan, MD  Clinical Professor of Pediatric Orthopedics, Department of Orthopedic Surgery, University of Oklahoma College of Medicine

J Andy Sullivan, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, Oklahoma State Medical Association, and Pediatric Orthopaedic Society of North America

Disclosure: Nothing to disclose.

Chief Editor

Craig C Young, MD  Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Director of Primary Care Sports Medicine Fellowship, Medical College of Wisconsin

Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Additional Contributors

Andrew K Chang, MD Associate Professor, Department of Emergency Medicine, Albert Einstein College of Medicine, Montefiore Medical Center

Andrew K Chang, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Neurology, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Thomas M DeBerardino, MD Associate Professor, Department of Orthopedic Surgery, Consulting Surgeon, Sports Medicine, Arthroscopy and Reconstruction of the Knee, Hip and Shoulder, Team Physician, Orthopedic Consultant to UConn Department of Athletics, University of Connecticut Health Center

Thomas M DeBerardino, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, and American Orthopaedic Society for Sports Medicine

Disclosure: Arthrex, Inc. Grant/research funds Other; Arthrex, Inc. Consulting fee Speaking and teaching; Genzyme Biosurgery. Inc. Grant/research funds Other; Musculoskeletal Transplant Foundation Grant/research funds Other; Histogenics Grant/research funds None

Janos P Ertl, MD Assistant Professor, Department of Orthopedic Surgery, Indiana University School of Medicine; Chief of Orthopedic Surgery, Wishard Hospital

Janos P Ertl, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, Hungarian Medical Association of America, and Sierra Sacramento Valley Medical Society

Disclosure: Nothing to disclose.

Gyorgy Kovacs, MD Consulting Surgeon, Department of Orthopedic Surgery, GOC Clinic

Disclosure: Nothing to disclose.

David B Levy, DO, FACEP, FAAEM Chairman, Department of Emergency Medicine, St Elizabeth Health Center; Associate Professor of Emergency Medicine, Northeastern Ohio Universities College of Medicine

David B Levy, DO, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American Medical Informatics Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Munisha Mehra Bhatia, MD General Academic Pediatrics, Faculty Development Fellow, Children's Memorial Hospital of Northwestern University

Munisha Mehra Bhatia, MD is a member of the following medical societies: Academic Pediatric Association and American Academy of Pediatrics

Disclosure: Nothing to disclose.

Albert W Pearsall IV, MD Associate Professor, Department of Orthopedic Surgery, University of South Alabama College of Medicine; Director, Section of Sports Medicine and Shoulder Service, Department of Orthopedic Surgery, University of South Alabama Medical Center

Disclosure: Nothing to disclose.

Andrew L Sherman, MD, MS Associate Professor of Clinical Rehabilitation Medicine, Vice Chairman, Chief of Spine and Musculoskeletal Services, Program Director, SCI Fellowship and PMR Residency Programs, Department of Rehabilitation Medicine, University of Miami, Leonard A Miller School of Medicine

Andrew L Sherman, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, and Association of Academic Physiatrists

Disclosure: Pfizer Honoraria Speaking and teaching

Mark S Slabinski, MD, FACEP, FAAEM Vice President, EMP Medical Group

Mark S Slabinski, MD, FACEP, FAAEM is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, and Ohio State Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

References

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  2. Krause BL, Williams JP, Catterall A. Natural history of Osgood-Schlatter disease. J Pediatr Orthop. Jan-Feb 1990;10(1):65-8. [Medline].

  3. Weiss JM, Jordan SS, Andersen JS, Lee BM, Kocher M. Surgical treatment of unresolved Osgood-Schlatter disease: ossicle resection with tibial tubercleplasty. J Pediatr Orthop. Oct-Nov 2007;27(7):844-7. [Medline].

  4. Demirag B, Ozturk C, Yazici Z, Sarisozen B. The pathophysiology of Osgood-Schlatter disease: a magnetic resonance investigation. J Pediatr Orthop B. Nov 2004;13(6):379-82. [Medline].

  5. Kujala UM, Kvist M, Heinonen O. Osgood-Schlatter's disease in adolescent athletes. Retrospective study of incidence and duration. Am J Sports Med. Jul-Aug 1985;13(4):236-41. [Medline].

  6. Gholve PA, Scher DM, Khakharia S, Widmann RF, Green DW. Osgood Schlatter syndrome. Curr Opin Pediatr. Feb 2007;19(1):44-50. [Medline].

  7. Ducher G, Cook J, Spurrier D, Coombs P, Ptasznik R, Black J, et al. Ultrasound imaging of the patellar tendon attachment to the tibia during puberty: a 12-month follow-up in tennis players. Scand J Med Sci Sports. Feb 2010;20(1):e35-40. [Medline].

  8. Ducher G, Cook J, Lammers G, Coombs P, Ptazsnik R, Black J, et al. The ultrasound appearance of the patellar tendon attachment to the tibia in young athletes is conditional on gender and pubertal stage. J Sci Med Sport. Jan 2010;13(1):20-3. [Medline].

  9. LAZERTE GD, RAPP IH. Pathogenesis of Osgood-Schlatter's disease. Am J Pathol. Jul-Aug 1958;34(4):803-15. [Medline]. [Full Text].

  10. EHRENBORG G. The Osgood-Schlatter lesion. A clinical study of 170 cases. Acta Chir Scand. Aug 1962;124:89-105. [Medline].

  11. EHRENBORG G. The Osgood-Schlatter lesion. A clinical and experimental study. Acta Chir Scand Suppl. 1962;Suppl 288:1-36. [Medline].

  12. Pihlajamäki HK, Mattila VM, Parviainen M, Kiuru MJ, Visuri TI. Long-term outcome after surgical treatment of unresolved Osgood-Schlatter disease in young men. J Bone Joint Surg Am. Oct 2009;91(10):2350-8. [Medline].

  13. Binazzi R, Felli L, Vaccari V, Borelli P. Surgical treatment of unresolved Osgood-Schlatter lesion. Clin Orthop Relat Res. Apr 1993;202-4. [Medline].

  14. Orava S, Malinen L, Karpakka J, Kvist M, Leppilahti J, Rantanen J, et al. Results of surgical treatment of unresolved Osgood-Schlatter lesion. Ann Chir Gynaecol. 2000;89(4):298-302. [Medline].

  15. Trail IA. Tibial sequestrectomy in the management of Osgood-Schlatter disease. J Pediatr Orthop. Sep-Oct 1988;8(5):554-7. [Medline].

 
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Radiograph of a patient who is skeletally mature. Note that the tibial tubercle is enlarged and there is an ossicle. A bursa was overlying this.
Radiograph of a patient who is skeletally immature. The tubercle is elongated and fragmented
Image courtesy of John T. Killion, MD; OSA Pediatric Orthopaedics
Image courtesy of John T. Killion, MD; OSA Pediatric Orthopaedics
 
 
 
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