eMedicine Specialties > Emergency Medicine > Trauma & Orthopedics

Osgood-Schlatter Disease: Differential Diagnoses & Workup

Author: Andrew K Chang, MD, Associate Professor, Department of Emergency Medicine, Albert Einstein College of Medicine, Montefiore Medical Center
Contributor Information and Disclosures

Updated: Apr 22, 2009

Differential Diagnoses

Fractures, Tibia and Fibula

Other Problems to Be Considered

Quadriceps tendon avulsion
Patellofemoral stress syndrome
Pes anserinus bursitis
Chondromalacia patellae
Osteomyelitis of the proximal tibia
Patellar tendonitis
Sinding-Larsen-Johansson syndrome
Hoffa's syndrome
Synovial plica injury
Tibial tubercle fracture

Workup

Laboratory Studies

  • Laboratory evaluation is not indicated for Osgood-Schlatter disease unless other diagnoses are being entertained.

Imaging Studies

  • Knee radiography (anteroposterior and lateral)
    • The Osgood-Schlatter lesion is best seen on the lateral view with the knee in slight internal rotation of 10-20 degrees.
    • Not all patients with Osgood-Schlatter disease need radiography since the diagnosis is clinical. Plain films are helpful to rule out other etiologies, such as neoplasm, acute tibial apophyseal fracture, and infection.
    • Superficial ossicle in the patellar tendon
    • Irregular ossification of the proximal tibial tuberosity
    • Calcification within the patellar tendon
    • Thickening of the patellar tendon
    • Soft tissue edema proximal to the tibial tuberosity
  • Bone scan may demonstrate increased uptake in the area of the tibial tuberosity.
  • Magnetic resonance imaging
    • MRI may assist in diagnosis of an atypical presentation. It may eventually play a role in staging of the disease and prognosticating the clinical course. The role in diagnosis, prognostication, and management is currently limited.3

Procedures

  • Corticosteroid injections are not recommended because of case reports of complications, primarily related to subcutaneous atrophy.

More on Osgood-Schlatter Disease

Overview: Osgood-Schlatter Disease
Differential Diagnoses & Workup: Osgood-Schlatter Disease
Treatment & Medication: Osgood-Schlatter Disease
Follow-up: Osgood-Schlatter Disease
Multimedia: Osgood-Schlatter Disease
References
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References

  1. 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].

  2. 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].

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

  4. 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].

  5. Aparicio G, Abril JC, Calvo E, Alvarez L. Radiologic study of patellar height in Osgood-Schlatter disease. J Pediatr Orthop. Jan-Feb 1997;17(1):63-6. [Medline].

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

  7. Bloom OJ, Mackler L, Barbee J. Clinical inquiries. What is the best treatment for Osgood-Schlatter disease?. J Fam Pract. Feb 2004;53(2):153-6. [Medline].

  8. Dunn JF. Osgood-Schlatter disease. Am Fam Physician. Jan 1990;41(1):173-6. [Medline].

  9. Flowers MJ, Bhadreshwar DR. Tibial tuberosity excision for symptomatic Osgood-Schlatter disease. J Pediatr Orthop. May-Jun 1995;15(3):292-7. [Medline].

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

  11. Hussain A, Hagroo GA. Osgood-Schlatter disease. Sports Exer Injury. 1996;2:202-206.

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

  13. Micheli LJ. The traction apophysitises. Clin Sports Med. Apr 1987;6(2):389-404. [Medline].

  14. Rostron PK, Calver RF. Subcutaneous atrophy following methylprednisolone injection in Osgood-Schlatter epiphysitis. J Bone Joint Surg Am. Jun 1979;61(4):627-8. [Medline].

  15. Smith JB. Knee problems in children. Pediatr Clin North Am. Dec 1986;33(6):1439-56. [Medline].

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Further Reading

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Keywords

Osgood-Schlatter disease, OS, OS disease, knee pain, knee injury, apophysitis tibialis adolescentium, Schlatter's disease, Schlatter disease, Schlatter-Osgood disease, traction apophysitis, partial avulsion fracture, proximal tibial tuberosity, patellar insertion, extra-articular disease, quadriceps atrophy, exercise, chronic microtrauma, overuse of quadriceps muscle, repetitive jumping sports, rapid skeletal growth

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Contributor Information and Disclosures

Author

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.

Medical Editor

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.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

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.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD, Medical Director, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

 
 
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