Medication Summary
The only medications that need to be prescribed are nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief and reduction of local inflammation (any NSAID may be used). However, one author concluded that anti-inflammatory drugs are not particularly beneficial in the management of Osgood-Schlatter disease.
Nonsteroidal Anti-Inflammatory Drugs
Class Summary
Short-term NSAIDs may be used for pain relief. Steroids are not recommended for use in this condition. NSAIDs have analgesic, anti-inflammatory, and antipyretic activities. Their mechanism of action is not known, but they may inhibit cyclo-oxygenase activity and prostaglandin synthesis. Other mechanisms may exist as well, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell membrane functions.
NSAIDs are commonly used for relief of mild to moderate pain. Although the effects of NSAIDs in the treatment of pain tend to be patient specific, ibuprofen is usually the DOC for initial therapy. Other options include naproxen, flurbiprofen, and ketoprofen.
Ibuprofen (Motrin, Advil, Ultraprin )
This is the drug of choice for patients with mild to moderate pain. It inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.
Ketoprofen
Ketoprofen is used for the relief of mild to moderate pain and inflammation. Small dosages initially are indicated in small and elderly patients and in those with renal or liver disease.
Doses over 75 mg do not increase therapeutic effects. Administer high doses with caution, and closely observe the patient for his or her response.
Naproxen (Naprelan, Anaprox, Aleve, Naprosyn)
This drug is used for the relief of mild to moderate pain. It inhibits inflammatory reactions and pain by decreasing the activity of cyclo-oxygenase, which results in a decrease of prostaglandin synthesis.
Flurbiprofen
Flurbiprofen may inhibit the cyclo-oxygenase enzyme, which in turn inhibits prostaglandin biosynthesis. These effects may result in analgesic, antipyretic, and anti-inflammatory activities.
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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.
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Radiograph of a patient who is skeletally immature. The tubercle is elongated and fragmented.
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Courtesy of John T Killion, MD, OSA Pediatric Orthopaedics.
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Courtesy of John T Killion, MD, OSA Pediatric Orthopaedics.
