Case 53: Osgood-Schlatter Disease

What is the classic presentation of SCFE?

An overweight male adolescent with knee or hip pain, and difficulty with hip flexion, internal rotation, and abduction

What are patients with SCFE at increased risk for?

Avascular necrosis of the femoral head

What are some constitutional signs that would raise suspicion that something else is going on?

Fever, joint erythema, fatigue, weight loss, night sweats, bruising, and cough

Is any imaging required to make the diagnosis of Osgood-Schlatter?

No, it can be made clinically

If a 12 year old athletic boy presents with knee pain that increases with activity and pain and swelling over the tibial tubercle, what is the most likely diagnosis?

Osgood-Schlatter disease

What is the definition of Osgood-Schlatter?

Painful inflammation of the tibial tubercle

What are some other conditions that should be included in the differential for knee pain in an adolescent?

Patellofemoral syndrome, patellar tendonitis, iliotibial band syndrome, and SCFE

What is the typical management for a patient with Osgood-Schlatter?

Rest and ice after activity, and if severe immobilization with the use of crutches

What are some of the motions that exacerbate pain of Osgood-Schlatter?

Running and jumping because these cause traction and microstress to the tibial tubercle