Osgood Schlatter’s disease (Osteochondritis of tibial tubercle)
Osgood Schlatter’s disease is a condition occurring in adolescent, characterized by painful disabling swelling around tibial tubercle. Disease is usually bilateral and is often preceded by trauma
Clinical features
There is pain and swelling at tibial tubercle. Signs of inflammation are classically absent. Quadriceps contraction against resistance is painful.
The course of disease is prolonged. The condition resolves by itself at the end of adolescence.
Investigations
X-ray shows soft tissue swelling with speckled calcification, anterior to tibial tubercle. There are multiple areas of ossification with osteopenic background.
Management:
Conservative management is effective in relieving symptoms. Cast in full extension unloads pull of quadriceps and allows revascularization.
NSAIDS are prescribed for analgesia and for their anti-inflammatory effect.
Surgery is done for intense symptoms and prolonged course.
Drill holes are made through tubercle for rapid vascularisation. Bone pegs may be inserted immobilizing the fragment (Bosworth’s procedure).
Premature fusion can later lead to genu recurvatum. Though unusual, is important sequel and when develops should be corrected.