Osgood-Schlatter Disease

The exact aetiology of Osgood-Schlatter disease is controversial. The generally excepted idea is that of a traction apophysitis of the patellar ligament on the tibial tubercle. It was described independently in 1903 by Osgood in the English literature and Schlatter in the German literature. This condition is the commonest cause of knee pain in preadolescents. 

The natural history of Osgood-Schlatter disease is self-limiting. 

Kocher MS, Czarnecki JJ, Andersen JS, Micheli LJ (2007) Internal fixation of juvenile osteochondritis dissecans lesions of the knee. Am J Sports Med. 35 712-718 Lazerte GD (1958) Pathogenesis of Osgood-Schlatters disease. AM J Pathol 34 803-815... 

Osteochondritis of the Tibiai Tubercle (Osgood-Schlatter Disease)... 

Osgood-Schlatter disease is a condition that is usually found in adolescent boys in which the... 

Fig. 14.28). Somewhat similar to the situation with the supraspinatus tendon, the examiner should be aware that the actual site of insertion is indicated by the prominence of the tuberosity and not by the anterior aspect of the tibial epiphysis. Short-axis US images of the patellar tendon are essential because the involvement by tendinopathy may occur out of the midline and possibly limited to the external borders of the tendon (Fig. 14.30). These planes depict a flattened tendon, shaped like a rectangle. In addition, they allow assessment of the medial and lateral patellar retinacula as sheet-like fibrous expansions attached on each side of the tendon (Fig. 14.30). Calcifications and ossification of the distal portion of the tendon can be encountered in asymptomatic subjects and are usually related to consequences of Osgood-Schlatter disease. 

Fig. 19.22a-c. Osgood-Schlatter disease, a Extended field-of-view longitudinal 12-5 MHz US image of the patellar tendon (arrowheads) in a 15-year-old adolescent with focal tenderness and chronic pain over the tibial tuberosity reveals a swollen and hypoechoic distal patellar tendon (asterisks) associated with bony irregularities and fragmentation (arrows) of the anterior tibial surface. P, patella. b,c Correlative color Doppler 12-5 MHz US images reveal a hypervascular pattern (arrows) within the intratendinous focal hypoechoic areas of the distal patellar tendon... 

In more subtle cases of apophyseal irritation with little displacement, US may demonstrate a double cortical sign as a result of subtle elevation of the most superficial layers of the bony cortex, a different appearance from that observed in Osgood-Schlatter disease (Fig. 19.28). In other instances, the injury causes stripping of the most external layers of cartilage or fibrocartilage that are superficial to... 

Fig. 4.15. Ultrasound demonstrating Osgood Schlatter s disease with focal swelling of the distal patellar tendon (PT) and increased flow on Doppler interrogation...

Only type 1A fractures can be treated with long-leg cast immobilisation. All other fracture types require open reduction and internal fixation. This is usually done by cannulated screws and washers. Fragmentation from previous Osgood-Schlatter s disease may make screw fixation less effective and this can be supplemented by tension band wire fixation. 

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