Osgood-Schlatter Disease in Emergency Medicine

Author: Andrew K Chang, MD; Chief Editor: Rick Kulkarni, MD more...

Updated: May 5, 2010

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Background
Pathophysiology
Epidemiology
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Background

Osgood-Schlatter (OS) disease is one of the most common causes of knee pain in the adolescent. Consisting of pain and edema of the tibial tubercle (and hence this is an extra-articular disease), Osgood-Schlatter disease is generally a benign, self-limited knee condition associated with traction apophysitis of the tibial tubercle due to repetitive strain on the secondary ossification center of the tibial tubercle.

Paget first described the clinical syndrome in 1891. In 1903, Osgood and Schlatter published separate papers on the subject. Because of a lack of a precise definition, differentiating Osgood-Schlatter disease from avulsion fractures of the tibial tubercle is difficult.

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.

Pathophysiology

Histologic studies suggest a traumatic etiology for Osgood-Schlatter disease. Bone growth is faster than soft tissue growth, which may result in muscle tendon tightness across the joint and loss of flexibility.

During periods of rapid growth, stress from contraction of the quadriceps is transmitted through the patellar tendon onto a small portion of the partially developed tibial tuberosity. This may result in a partial avulsion fracture through the ossification center. Eventually, secondary heterotopic bone formation occurs in the tendon near its insertion, producing a visible lump. Approximately 25% of patients have bilateral lesions.

In an MRI study of 20 patients with Osgood-Schlatter disease, the patellar tendon was noted to attach more proximally and in a broader area to the tibia in patients with Osgood-Schlatter disease.^[1]

Frequency

United States

The frequency of Osgood-Schlatter disease is not known, but the condition is uncommon.

International

One Finnish study found that Osgood-Schlatter disease affected 13% of athletes.

Mortality/Morbidity

Osgood-Schlatter disease is typically a benign and self-limited condition that waxes and wanes but often takes months to years to resolve entirely.

Sex

Osgood-Schlatter disease occurs more frequently in boys, probably because a greater number of boys participate in sports.

Age

Osgood-Schlatter disease usually is seen in the adolescent years after undergoing a rapid growth spurt the previous year.
Girls who are affected are typically aged 10-11 years but can range from 8-12 years.
Boys who are affected are typically aged 13-14 years but can range from 12-15 years.

Proceed to Clinical Presentation

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.

Specialty Editor Board

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 Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

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.

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

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

References

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