Osgood-Schlatter disease
Osgood-Schlatter disease is a painful swelling of the bump on the front of the upper
tibia (lower leg bone) in an area called the anterior tibial tubercle.
Information about of Osgood-Schlatter disease
To understand what's going on in Osgood-Schlatter disease , you need to understand a
bit about how bones grow. Bones grow by initially forming a cartilage template, onto which
calcium is deposited to form bone, (this process is called "ossification", and
when the cartilage has been turned into bone it is "ossified"). Osgood-Schlatter
disease is an abnormality in this normal development of bones, and generally affects
the joints. It resembles, but is distinct from hip dysplasia in many respects, in
that it too is a developmental disorder of cartilage-bone formation. The ends of a bone
grow in two places. Firstly, at the epiphyseal plate. This is a cartilaginous region of
the bone, the location of the greatest part of growth. Secondly, the cartilage which
overlies the end of the bone, at the joint, also grows, and becomes ossified at the
junction of bone and cartilage. You can see these areas of growth on this picture:
There are two main forms of Osgood-Schlatter disease . If the problem occurs at the
epiphyseal plate, then the overlying bone will not join properly to the main shaft of the
bone. If the problem occurs at the joint surface, then a thickened area of cartilage
develops which is only loosely attached to the underlying bone. This can shear, resulting
in the formation of a flap. This is known as osteochondritis dissecans (OCD).
Causes of Osgood-Schlatter disease
Many theories have been advanced to account for Osgood-Schlatter disease , but none has
proven fully satisfactory. Stress and ischemia (reduced blood supply) are two of the most
commonly mentioned factors. Athletic young children are often affected when they
overstress their developing limbs with a particular repetitive motion. Many cases are
idiopathic, meaning that no specific cause is known.
The most common symptom for most types of Osgood-Schlatter disease is simply pain
at the affected joint, especially when pressure is applied. Locking of a joint or limited
range of motion at a joint can also occur.
Scheuermann's disease can lead to serious kyphosis (hunchback condition) due to erosion
of the vertebral bodies. Usually, however, the kyphosis is mild, causing no further
symptoms and requiring no special treatment.
Diagnosis of Osgood-Schlatter disease
A doctor can make a diagnosis during a physical examination. A
bone X-ray may be normal, may show soft tissue swelling, or may demonstrate fragmentation
of the the tibial tubercle.
Treatment of Osgood-Schlatter disease
Initial treatment includes rest, ice, and nonsteroidal
anti-inflammatory medication (NSAIDS, for example ibuprofen). In many cases, the condition
will disappear with rest, pain medication, and the reduction of sports or exercise.
In the rare case where symptoms do not resolve, the affected leg may be immobilized by
a cast or brace until healing takes place. This typically takes 6 to 8 weeks. Crutches can
be used for walking to keep weight off the affected leg.
Rarely, surgery may be needed if the initial treatment fails. |
