Osgood-Schlatter disease in Adult
Classic history and presentation: Affected patients often present with an acutely tender and swollen bump over the tibial tubercle. It may present bilaterally or unilaterally. Some patients may have a limp. OS is usually exacerbated by exercise and improves with rest.
Prevalence: OS was historically shown to affect predominantly boys, but more recent investigations have shown similar rates in girls, likely due to the rise in female athletic participation over the last several decades. It is estimated to affect between 10%-20% of adolescent athletes. Girls typically experience symptoms at an earlier age than boys (10-13 years versus 11-14 years, respectively), corresponding with the earlier onset of pubertal growth in girls.
Risk factors: Risk factors include participation in sports that involve jumping and pivoting, including soccer, basketball, gymnastics, and volleyball. Additionally, there may be limited evidence to show associations with increased body weight and tightness / flexibility of the quadriceps and hamstring muscles.
Pathophysiology: The underlying pathophysiology of OS is poorly understood. Its association with sports participation has led to the hypothesis that it is related to repeated small injuries to the developing knee associated with traction from the patellar tendon.
M92.40 – Juvenile osteochondrosis of patella, unspecified knee
72047008 – Juvenile osteochondrosis of tibial tubercle
Differential Diagnosis & Pitfalls
- Osteochondritis dissecans
- Patellofemoral pain syndrome
- Avulsion fracture of the tibial tuberosity
- Pes anserine bursitis
- Sinding-Larsen-Johansson disease
- Patellar / quadriceps tendonitis
- Infrapatellar fat pad syndrome (Hoffa's disease)
- Infrapatellar bursitis
- Bone tumors
- Plica syndrome
- Tibial stress fracture