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Osgood–Schlatter disease (OSD) is a self-limiting traction apophysitis of the tibial tuberosity, occurring due to repetitive stress from the patellar tendon on a developing ossification center.
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Osgood-Schlatter disease - causes, symptoms, diagnosis, treatment, pathology
| Feature | Description |
|---|---|
| Mechanism | Repetitive strain on the immature secondary ossification center of the tibial tubercle |
| Growth period | Occurs during adolescence (age 10–15) |
| Gender predilection | More common in males (but increasing in active females) |
| Laterality | Bilateral in 20–30% of cases |
| Feature | Description |
|---|---|
| Symptoms | Anterior knee pain, worsened by activity (jumping, squatting) |
| Pain location | Over tibial tuberosity, tender to palpation |
| Swelling | Localized, firm bump may be present |
| Onset | Gradual; associated with periods of increased activity |
| Range of motion | Normal or slightly painful terminal extension |
https://doi.org/10.1148/rg.293085163
| Modality | Imaging features |
|---|---|
| XR | Radiographs are usually diagnostic in moderate-to-severe cases. |
| • Tibial tubercle fragmentation: Irregular or fragmented secondary ossification center | |
| • Soft-tissue swelling: May be visible anterior to tibial tubercle | |
| • Patellar tendon thickening: Occasionally appreciated | |
| • Bony prominence: Chronic cases may develop ossicle or enlarged tubercle | |
| US | • Hypoechoic swelling: Apophyseal edema |
| • Fragmentation: May be visible within tibial tubercle | |
| • Patellar tendon changes: Tendon thickening or inflammation near insertion | |
| MR | • T1: Fragmented or irregular tibial tubercle apophysis |
| • T2/STIR: High signal (edema) in apophysis, adjacent marrow, or patellar tendon | |
| • Chronic phase: Fibrous changes, possible patellar tendinosis, and ossicle formation |
Osgood-Schlatter syndrome in three boys aged 14–16 years with varying degrees of the disease. (a) Radiograph shows a punctate focus of ossification (arrow) at the site of the patellar tendon insertion. (b) Radiograph shows heterotopic bone formation at the tibial tubercle with overlying soft-tissue swelling. (c) Radiograph shows heterotopic bone formation. (d) Corresponding MR image shows edema at the tibial tubercle and in adjacent soft tissues (arrowhead)
Dupuis CS, Westra SJ, Makris J, Wallace EC. Injuries and Conditions of the Extensor Mechanism of the Pediatric Knee. Radiographics. 2009;29(3):877-886. doi:https://doi.org/10.1148/rg.293085163
Osgood–Schlatter disease on the ultrasound image. (a) Irregular contour of the ossification center of the tibial tuberosity apophysis. (b) Increased vascularity at the attachment site of the patellar ligament observed on Power Doppler ultrasound.
Maruszczak K, Madej T, Gawda P. Lower Limb Osteochondrosis and Apophysitis in Young Athletes—A Comprehensive Review. Applied Sciences. 2024; 14(24):11795. https://doi.org/10.3390/app142411795