Osgood-Schlatter disease

Osgood-Schlatter Disease

Osgood-Schlatter disease

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  • Osgood-Schlatter disease is a common cause of knee pain in young children and adolescents who are still growing.
  • Most children will develop Osgood-Schlatter disease in one knee only, but some will develop it in both.
  • Athletic young people are most commonly affected by Osgood-Schlatter disease—particularly boys between the ages of 10 and 15 who play games or sports that include frequent running and jumping.
  • Treatment for Osgood-Schlatter disease includes reducing the activity that makes it worse, icing the painful area, using kneepads or a patellar tendon strap, and anti-inflammatory medication.
  • Surgery is rarely used to treat Osgood-Schlatter disease.

Osgood-Schlatter disease is a condition that causes pain and swelling below the knee joint, where the patellar tendon attaches to the top of the shinbone (tibia), a spot called the tibial tuberosity. There may also be inflammation of the patellar tendon, which stretches over the kneecap.

Osgood-Schlatter disease is most commonly found in young athletes who play sports that require a lot of jumping and/or running.

What causes Osgood-Schlatter disease?

Osgood-Schlatter disease is caused by irritation of the bone growth plate. Bones do not grow in the middle, but at the ends near the joint, in an area called the growth plate.

While a child is still growing, these areas of growth are made of cartilage instead of bone.

The cartilage is never as strong as the bone, so high levels of stress can cause the growth plate to begin to hurt and swell.

The tendon from the kneecap (patella) attaches down to the growth plate in the front of the leg bone (tibia). The thigh muscles (quadriceps) attach to the patella, and when they pull on the patella, this puts tension on the patellar tendon. The patellar tendon then pulls on the tibia, in the area of the growth plate.

Any movements that cause repeated extension of the leg can lead to tenderness at the point where the patellar tendon attaches to the top of the tibia. Activities that put stress on the knee—especially squatting, bending or running uphill (or stadium steps)—cause the tissue around the growth plate to hurt and swell.

It also hurts to hit or bump the tender area. Kneeling can be very painful.

How is Osgood-Schlatter disease treated?

Osgood-Schlatter disease usually goes away with time and rest. Sports activities that require running, jumping or other deep knee-bending should be limited until the tenderness and swelling subside. Kneepads can be used by athletes who participate in sports where the knee might make contact with the playing surface or other players.

Some athletes find wearing a patellar tendon strap below the kneecap can help decrease the pull on the tibial tubercle. Ice packs after activity are helpful, and ice can be applied two to three times a day, 20 to 30 minutes at a time, if necessary. The appropriate time to return to sports will be the athlete’s pain tolerance.

An athlete will not be “damaging” his or her knee by playing with some pain.

Your doctor may also recommend stretching exercises to increase flexibility in the front and back of the thigh (quadriceps and hamstring muscles). This can be achieved either through home exercises or formal physical therapy.

Medicine, such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs)— ibuprofen (Aleve and Advil)—can be used to help control pain. If your child needs multiple doses of medication daily and the pain affects their daily activities, there should be a discussion on resting from the sport.

Is surgery ever needed for Osgood-Schlatter disease?

In almost every case, surgery is not needed. This is because the cartilage growth plate eventually stops its growth and fills in with bone when the child stops growing.

The bone is stronger than cartilage and less prone to irritation. The pain and swelling go away because there is no new growth plate to be injured.

Pain linked to Osgood-Schlatter disease almost always ends when an adolescent stops growing.

In rare cases, the pain persists after the bones have stopped growing. Surgery is recommended only if there are bone fragments that did not heal. Surgery is never done on a growing athlete, since the growth plate can be damaged.

If pain and swelling persist despite treatment, the athlete should be re-examined by a doctor regularly. If the swelling continues to increase, the patient should be re-evaluated.

Source: https://www.hopkinsmedicine.org/health/conditions-and-diseases/osgoodschlatter-disease

Osgood-Schlatter Disease: Causes, Symptoms, Treatment, Pain Relief

Osgood-Schlatter disease

Osgood-Schlatter disease is a condition that happens when a tendon in the knee (the patellar tendon) pulls against the top of the shinbone. This causes pain in the knee and the upper shin.

Tendons are bands of tissue that connect muscles to bones. The patellar tendon pulls on an area of the shinbone where new bone is forming, called the growth plate.

The pulling causes pain and inflammation (swelling and irritation). A hard bump may also grow right below the knee as the growth plate hardens.

People with Osgood-Schlatter disease usually get better with rest, over-the-counter pain medication and time.

Osgood-Schlatter disease is sometimes referred to as growing pains or jumper’s knee.

How common is Osgood-Schlatter disease?

Osgood-Schlatter disease is very common. It is the most common cause of knee pain in children and teenagers.

Who is affected by Osgood-Schlatter disease?

Osgood-Schlatter disease happens in children and adolescents who are going through a growth spurt. This typically occurs around ages 11 to 14. Because this condition is often related to an activity or motion, it is more common in adolescents who:

  • Play sports that require jumping or bending the knee (volleyball and basketball).
  • Have tight quadriceps (thigh muscles).

What is the patellar tendon?

The patellar tendon is a connective band of tissue in the knee. This tendon holds the kneecap and the shinbone together. It attaches right below the kneecap and then stretches to the part of the shinbone where new bone grows (growth plate). Because of this connection point, there can be pain when a child goes through a growth spurt.

How do people get Osgood-Schlatter disease?

Children and adolescents get Osgood-Schlatter disease when they play sports that put repeated stress on the patellar tendon. There are certain activities –running and jumping—that cause your leg muscles to pull the patellar tendon, which pulls on the growth plate.

Sometimes called growing pains, Osgood-Schlatter disease often occurs when children are going through a growth spurt. During periods of rapid growth, the bones, muscles, and tendons shift and grow larger. These changes can put more stress on the patellar tendon and growth plate.

What are the symptoms of Osgood-Schlatter disease?

The main symptoms of Osgood-Schlatter disease are:

  • Swelling.
  • Tenderness.
  • Pain just below the kneecap.

Pain usually develops gradually over time, though it can appear suddenly. The pain may be worse in one knee than in the other, and it often gets worse when you run, jump, or climb.

A hard, painful bump can also appear on the front of the knee below the kneecap. This bump is new bone that grows in the place where the tendon pulls on the growth plate. Though the pain will go away, the bump may remain even after the child has grown up.

Last reviewed by a Cleveland Clinic medical professional on 11/06/2019.

References

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Source: https://my.clevelandclinic.org/health/diseases/21171-osgood-schlatter-disease

Osgood-Schlatter Disease: Background, Etiology, Epidemiology

Osgood-Schlatter disease

Author

James R Gregory, MD Assistant Professor, Department of Orthopedic Surgery and Rehabilitation, University of Oklahoma Health Sciences Center College of Medicine

James R Gregory, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Mid-America Orthopaedic Association, 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, 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, Phi Beta Kappa

Disclosure: Nothing to disclose.

Additional Contributors

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, Pediatric Orthopaedic Society of North America

Disclosure: Nothing to disclose.

Acknowledgements

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

Source: https://emedicine.medscape.com/article/1993268-overview

What Are the Signs & Symptoms of Osgood-Schlatter Disease?

OSD typically causes pain and swelling below the kneecap. The pain usually gets worse with running, jumping, going up stairs, and walking up hills. Severe pain may lead to limping. OSD can happen in one or both knees.

What Causes Osgood-Schlatter Disease?

Osgood-Schlatter disease happens during the growth spurt of puberty. During a child's growth spurt, the bones, muscles, and tendons grow at different rates.

In OSD, the tendon that connects the shinbone to the kneecap pulls on the growth plate at the top of the shinbone.

Activities and sports cause this to happen over and over, which causes injury to the growth plate. This injury leads to the pain of OSD.

Who Gets Osgood-Schlatter Disease?

OSD usually happens in kids that are:

  • in their growth spurt (usually around 9–14 years old)
  • active in sports or activities that involve a lot of running or jumping

OSD is an overuse injury. This means it happens when a child does the same movements over and over again.

How Is Osgood-Schlatter Disease Diagnosed?

To diagnose Osgood-Schlatter disease, health care providers:

  • ask about physical activities
  • do an exam

Usually no testing is needed. Sometimes the health care provider orders an X-ray to check for other knee problems.

How Is Osgood-Schlatter Disease Treated?

Kids with Osgood-Schlatter disease need to limit activities that cause pain that makes it hard to do that activity. For example, it's OK for a child who feels a little pain when running to keep running. But if running causes a limp, the child should stop and rest. When the pain is better (usually after a day or two), the child can try the activity again.

Sometimes health care providers recommend physical therapy (PT) to keep leg muscles strong and flexible while a child gets better. It doesn't happen often, but some kids might need a total break from all sports and physical activities.

To help your child feel more comfortable while healing from OSD:

  • Put ice or a cold pack on the knee every 1–2 hours for 15 minutes at a time. Put a thin towel between the ice and your child's skin to protect it from the cold.
  • If your health care provider says it's OK, you can give ibuprofen (Advil, Motrin, or store brand) or acetaminophen (Tylenol or store brand). Follow the directions that come with the medicine for how much to give and how often to give it.

How Long Does Osgood-Schlatter Disease Last?

Osgood-Schlatter disease usually goes away when the bones stop growing. Typically, this is when a teen is between 14 and 18 years old.

Can Kids With Osgood-Schlatter Disease Still Do Sports?

Yes, kids with OSD can usually do their normal activities, including sports, as long as:

  • The pain is not bad enough to interfere with the activity.
  • The pain gets better within 1 day with rest.

For kids who play sports, it can help to:

  • Wear shock-absorbing insoles in their sneakers and cleats.
  • Put a heating pad or warm washcloth on the knee for 15 minutes before sports.
  • Put ice on the knee for 15 minutes after the activity (with a towel between the ice and the skin).
  • Wear protective kneepads, especially for wrestling, basketball, and volleyball.
  • Stretch before and after sports.

Looking Ahead

Long-term effects of OSD usually aren't serious. Some kids may have a painless bump below the knee that doesn't go away. Very rarely, doctors will do surgery to remove a painful bump below the knee.

Some adults who had OSD as kids or teens have some pain with kneeling. If your child still has knee pain after the bones stop growing, see your health care provider. The provider can check for other causes of knee pain.

Reviewed by: Alvin Su, MD

Date reviewed: January 2019

Source: https://kidshealth.org/en/parents/osgood.html

Osgood-Schlatter Disease: Symptoms, Diagnosis & Treatments

Osgood-Schlatter disease

Osgood-Schlatter disease is a common cause of knee pain in growing children and young teenagers. It’s characterized by inflammation in the area just below the knee. This area is where the tendon from the kneecap attaches to the shinbone (tibia). The condition most often develops during growth spurts.

During the growth spurts of adolescence, certain muscles and tendons grow quickly and not always at the same rate. With physical activity, differences in the size and strength of the quadriceps muscle can put more stress on the growth plate near the top of the shinbone.

The growth plate is weaker and more prone to injury than other parts of the bone. As a result, it can become irritated during physical stress and overuse. The irritation can result in a painful lump below the kneecap. This is the main sign of Osgood-Schlatter disease.

Osgood-Schlatter disease is typically diagnosed in adolescents during the beginning of their growth spurts. Growth spurts usually start between ages 8 and 13 for girls, and between ages 10 and 15 for boys. Teenage athletes who play sports that involve jumping and running are more ly to develop the disease.

In most cases, Osgood-Schlatter disease can be treated successfully with simple measures, such as rest and over-the-counter medication.

Common symptoms of Osgood-Schlatter disease include:

  • knee or leg pain
  • swelling, tenderness, or increased warmth under the knee and over the shinbone
  • pain that gets worse with exercise or high-impact activities, such as running
  • limping after physical activity

The severity of these symptoms often varies from person to person. Some individuals experience only mild pain during certain activities. Others experience constant, debilitating pain that makes it difficult to do any physical activity. The discomfort can last from a few weeks to several years. The symptoms typically go away once the growth spurt of adolescence is finished.

Osgood-Schlatter disease most commonly occurs in children who participate in sports that involve running, jumping, or twisting. These include:

  • basketball
  • volleyball
  • soccer
  • long-distance running
  • gymnastics
  • figure skating

Osgood-Schlatter disease tends to affect boys more often than girls. The age at which the condition occurs can vary by sex, because girls experience puberty earlier than boys. It usually develops in girls between ages 11 and 12 and in boys between ages 13 and 14.

A doctor will perform a physical exam and check your child’s knee for swelling, pain, and redness. This will usually provide the doctor with enough information to make an Osgood-Schlatter disease diagnosis. In some cases, the doctor may want to perform a bone X-ray to rule out other potential causes of knee pain.

Osgood-Schlatter disease usually resolves on its own once a growth spurt ends. Until then, treatment is focused on relieving symptoms, such as knee pain and swelling. Treatment typically involves:

  • icing the affected area two to four times a day, or after doing physical activity
  • taking over-the-counter pain relievers, such as ibuprofen or acetaminophen
  • resting the knee or reducing physical activity
  • wrapping the knee or wearing a knee brace
  • stretching
  • physical therapy

Some children may be able to participate in low-impact activities, such as swimming or biking, as they recover. Others may need to stop participating in certain sports for several months so their bodies have time to heal properly. Talk to your child’s doctor about what activities are appropriate and when a break from sports is necessary.

Osgood-Schlatter disease usually doesn’t cause any long-term complications. In rare cases, children with the disease may experience chronic pain or ongoing swelling. However, taking over-the-counter pain relievers and applying ice to the area can usually ease this discomfort. Some children might also need surgery if the bone and tendons in their knee don’t heal correctly.

Though Osgood-Schlatter disease is usually a minor condition, getting a proper diagnosis and treatment can help prevent complications. If your child is experiencing symptoms of the condition, you should:

  • Schedule an appointment with your child’s doctor.
  • Make sure you child sticks to their treatment plan if they’re diagnosed with Osgood-Schlatter disease.
  • Attend all follow-up appointments and notify your child’s doctor if symptoms persist.

Source: https://www.healthline.com/health/osgood-schlatter-disease

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