eMedicine Specialties > Sports Medicine > Lower Limb

Osgood-Schlatter Disease: Differential Diagnoses & Workup

Author: Munisha Mehra Bhatia, MD, General Academic Pediatrics, Faculty Development Fellow, Children's Memorial Hospital of Northwestern University
Coauthor(s): Janos P Ertl, MD, Clinical Assistant Professor, Department of Orthopedic Surgery, Chief of Orthopedic Trauma, University of California at Davis; Director of Amputee Clinic, Kaiser Hospital; Gyorgy Kovacs, MD, Department of Orthopedic Surgery, Consulting Surgeon, GOC Clinic
Contributor Information and Disclosures

Updated: Apr 28, 2006

Differential Diagnoses

Femur Injuries and Fractures
Knee Osteochondritis Dissecans
Patellofemoral Joint Syndromes
Pes Anserine Bursitis

Other Problems to Be Considered

Sinding-Larson-Johansson syndrome
Osteomyelitis
Tibia, fibula, or femur fracture
Tumor
Perthes disease
Quadriceps tendon avulsion
Patellofemoral stress syndrome
Chondromalacia patellae
Patellar tendonitis
Infectious apophysitis
Soft tissue malignancy
Accessory ossification centers

Workup

Laboratory Studies

  • Laboratory studies are not required to make the diagnosis of OSD.

Imaging Studies

  • Imaging studies are not required to make the diagnosis of OSD; however, they often are used to rule out osteomyelitis, tumors, and other pathology.
  • Radiographs
    • A lateral projection with the knee in slight medial rotation is the preferred view. This view shows the greatest detail of the tibial tubercle.
    • When radiographs are obtained, the most common finding is that the knee films are normal, especially if the child is in the preossification phase.
    • The acute phase of OSD may reveal a prominent and elevated tibial tubercle with anterior soft tissue swelling.
    • In severe cases, radiographs may reveal radiodense fragments or ossicles separated from the tibial tuberosity.
    • Occasionally, the radiographs may reveal irregularity, fragmentation, or increased density of the ossification of the tibial tubercle. This pattern may be a normal variant in asymptomatic children.
  • Ultrasound may reveal a normal tubercle and signal changes consistent with thickening (more echogenic) in the patellar tendon and hypoechoic area of the adjacent soft tissue.
  • CT scan or MRI may reveal changes at the insertion of the patellar tendon.

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. Behrman R, Kliegman R, Nelson WE. Osgood-Schlatter disease. In: Nelson Textbook of Pediatrics. Vol 14. Philadelphia, Pa: WB Saunders; 1992:1705.

  2. 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].

  3. 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].

  4. Epstein B. Common problems affecting adolescents - Osgood Schlatter disease: A common cause of knee pain. In: Iowa Health Book: Family Practice. Iowa City, Iowa: The University of Iowa; 1995.

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

  6. Meisterling R, Wall E, Meisterling M. Coping with Osgood-Schlatter disease. In: The Physician and Sports Medicine. Vol 26. New York, NY: McGraw-Hill; 1998.

  7. Ross MD, Villard D. Disability levels of college-aged men with a history of Osgood-Schlatter disease. J Strength Cond Res. Nov 2003;17(4):659-63. [Medline].

  8. Staheli L. 2nd ed. Fundamentals of Pediatric Orthopedics. Philadelphia, Pa: Lippincott-Raven; 1998:56, 123.

  9. Tachdjian MO. Clinical Pediatric Orthopedics: The Art of Diagnosis and Principles of Management. Vol 1. Stamford, Conn: Appleton & Lange; 1997:107-108.

  10. Wall E. Osgood-Schlatter disease: Practical treatment for a self-limiting condition. In: The Physician and Sports Medicine. Vol 26. New York, NY: McGraw-Hill; 1998.

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Further Reading

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Keywords

OSD, tibial tubercle osteochondrosis, traction apophysitis, knee pain

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Contributor Information and Disclosures

Author

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: Ambulatory Pediatric Association and American Academy of Pediatrics
Disclosure: Nothing to disclose.

Coauthor(s)

Janos P Ertl, MD, Clinical Assistant Professor, Department of Orthopedic Surgery, Chief of Orthopedic Trauma, University of California at Davis; Director of Amputee Clinic, Kaiser Hospital
Janos P Ertl, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Hungarian Medical Association of America, Orthopaedic Trauma Association, and Sierra Sacramento Valley Medical Society
Disclosure: Nothing to disclose.

Gyorgy Kovacs, MD, Department of Orthopedic Surgery, Consulting Surgeon, GOC Clinic
Disclosure: Nothing to disclose.

Medical Editor

Andrew L Sherman, MD, Associate Professor, Departments of Neurological Surgery, Orthopedics, and Rehabilitation, University of Miami Miller School of Medicine
Andrew L Sherman, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American College of Sports Medicine, and American Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

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

Managing Editor

Marlene DeMaio, MD, Consulting Staff, Department of Orthopedic Surgery, Assistant Professor, Bone & Joint/Sports Medicine Institute, Naval Medical Center
Marlene DeMaio, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, American College of Sports Medicine, American Orthopaedic Foot and Ankle Society, and American Orthopaedic Society for Sports Medicine
Disclosure: Nothing to disclose.

CME Editor

Jon Whitehurst, MD, Consulting Staff, Rockford Orthopedic Associates
Disclosure: Nothing to disclose.

Chief Editor

William Jay Bryan, MD, Clinical Professor, Department of Orthopedic Surgery, Baylor University College of Medicine
William Jay Bryan, MD is a member of the following medical societies: Texas Orthopaedic Association
Disclosure: Nothing to disclose.

 
 
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