(See also Overview of Bone Disorders in Children.)
Osgood-Schlatter disease is an osteochondrosis, which is a group of disorders of the growth plates that occur when the child is growing rapidly. Doctors are not sure what causes osteochondrosis, but the disorders do seem to run in families. Köhler bone disease, Legg-Calvé-Perthes disease, and Scheuermann disease are other osteochondroses.
Osgood-Schlatter disease develops between the ages of 10 and 15 and usually affects only one leg. The disease is usually more common among boys, but this situation is changing as girls become more active in sports programs.
The cause of Osgood-Schlatter disease is thought to be repetitive, excessive pulling of the tendon of the kneecap (patella) where it attaches at the top of the shinbone. This attachment point is called the tibial tubercle.
The major symptoms of Osgood-Schlatter disease are pain, swelling, and tenderness at the tibial tubercle at the front of the knee just below the kneecap. The pain worsens with activity and is relieved with rest.
Doctors base the diagnosis of Osgood-Schlatter disease on an examination and the child's symptoms.
X-rays of the knee may show the tibial tubercle has enlarged or has broken into fragments. However, x-rays are generally not needed unless the child has other symptoms, such as pain and swelling that extend beyond the knee or pain that is accompanied by redness and warmth. These symptoms suggest another disorder, such as an injury or joint inflammation.
Symptoms of Osgood-Schlatter disease usually resolve after several weeks or months. Avoiding excessive exercise and deep knee bending helps reduce pain. However, doctors do allow children with Osgood-Schlatter disease to continue to participate in sports or exercise even when they are in pain.
Use of nonsteroidal anti-inflammatory drugs (NSAIDs), stretching exercises, and application of ice on the affected knee may help relieve the pain.
Rarely, the leg may need to be immobilized in plaster, a corticosteroid may need to be injected below the skin, or surgical procedures that involve the removal of fragments of bone, drilling, and grafting may be required.