Osgood–Schlatter Disease

Osgood–Schlatter disease (also known as tibial tubercle apophyseal traction injury) is an irritation of the patellar tendon at the tibial tuberosity.  The condition occurs in active boys and girls aged 9–16 years coinciding with periods of growth spurts. It occurs more frequently in boys than in girls. It has been suggested the difference is related to a greater participation by boys in sports and risk activities than by girls.

Lateral radiograph of the knee demonstrating fragmentation of the tibial tubercle with overlying soft tissue swelling.

The condition is usually self-limiting and is caused by stress on the patellar tendon that attaches the quadriceps muscle at the front of the thigh to the tibial tuberosity. Following an adolescent growth spurt, repeated stress from contraction of the quadriceps is transmitted through the patellar tendon to the immature tibial tuberosity. This can cause multiple subacute avulsion fractures along with inflammation of the tendon, leading to excess bone growth in the tuberosity and producing a visible lump which can be very painful when hit.

Diagnosis is made clinically, and treatment is conservative with rest, and if required acetaminophen (paracetamol) or ibuprofen. The condition usually resolves in a few months.