Osgood-Schlatter disease

Osgood-Schlatter disease is a disease in which the tibial tuberosity is susceptible to death. This is often caused by a growth spurt but also by intensive exercise. We mainly see this in children between 9 and 16 years old, in the middle of the growth phase. The child has pain while jumping, running or climbing stairs. The pain gradually gets worse. The doctor can make the diagnosis based on examination and sometimes an X-ray. The disease is often not recognized or dismissed as growing pains.

Osgood-Schlatter disease

This disease is named after an American orthopedic surgeon (Osgood) and a Swiss surgeon (Schlatter). This disease occurs in children between 9 and 16 years old. Of all young children who participate in intensive sports, an average of 15 to 20 percent will experience this. Children who do not exercise are affected by this in 5 to 10 percent of cases. Doctors only see a very small proportion of these children. Most children or parents dismiss the complaints as growing pains, which means the disease is never recognized. In Osgood-Schlatter disease, the tibial tuberosity dies.

Symptoms

Just below the knee is the tibial tuberosity (tuberosity tibiae). The tibia runs at the front of the lower leg, is the largest bone of the two (the fibula is smaller and narrower) and is located between the knee and ankle. The top of the shin bone consists of the tibial tuberosities, just below the knee. We distinguish the outer tibial tubercle and the inner tibial tubercle.
Symptoms that occur with Osgood-Schlatter disease include pain and swelling around the tibial tuberosity. The kneecap tendon (patellar tendon) can also be painful. The pain worsens when climbing stairs or when exerting great force on the kneecap. Patella alta is also often found: an elevation of the patella (kneecap). As a result, the kneecap can easily become dislocated when the thigh muscles are tensed. It is unknown whether patella alta is a cause or a consequence of Osgood-Schlatter disease. It is known that it more often occurs simultaneously with Osgood-Schlatter, especially in girls. Pressure on the tibial tuberosity is painful. Touching this is often painful enough to make a diagnosis. Sometimes the area feels warm and is clearly swollen.
Strongly tensing the thigh muscles during a knee bend worsens the complaints. This can be tested by pretending to sit down with your back straight: a knee bend where the muscles in the upper leg have to tense a lot. A clear pain is felt during this exercise. The pain can be felt on the right or left side: not always both shin bones are affected. This often has to do with the position of the leg or foot, which puts more force on one side. The pain often also occurs in the leg that exerts the most force. Rarely does it occur in both legs at the same time.

Cause

The disease mainly occurs in children between 9 and 16 years old. Girls start growing earlier and it often occurs between the ages of 9 and 13. In boys we mainly see it between the ages of 11 and 16. In general, the disease is more common in boys than girls. A growth spurt is probably the cause of the disease. Intensive sports can actually provoke the disease. We often see this in sports that place a lot of force on the knee: volleyball, basketball, jumping, running, athletics, etc. However, not every young athlete gets this disease. Why this is so is completely unknown. Hereditary factors do not appear to play a role in this.

Therapy

To make the diagnosis, the painful area will first be examined by palpation and the clinical picture will be examined. An X-ray can sometimes be useful, but sometimes an abnormality can be seen on the X-ray that is not due to this disease. Growing children sometimes show an abnormality, which later corrects itself. The disease does not require treatment. It will disappear again by itself. Until the time of healing, the leg should not be subjected to sports or heavy exertion. Light exercise is good: it promotes recovery and keeps the muscles flexible. In case of severe complaints, a painkiller may be prescribed. This prevents the leg from being burdened at all. The child will not suffer any adverse effects after recovery. The pain complaints disappear and the leg can be used normally again.

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