Osgood-Schlatters

Case
This young football player presented with a short history of localised anterior knee pain. This was associated with localised tenderness over the tibial tubercle but no other significant findings. The pain was clearly made worse by activity and improved by rest. He had been playing in excess of 10 organised football sessions per week prior to the onset of his symptoms.

Findings
This player has a normal x-ray series of his knee. An MRI scan has shows striking marrow edema involving the anterior tibial epiphysis, the tibial tubercle and the patella tendon attachment at the tibial metaphysis. These findings are fairly florid but are consistent with Osgood-Schlatters disease.

Discussion
Osgood-Schlatter’s disease is an overload condition involving the tibial apophysis. It is very common in young active children and typically resolves spontaneously with time and a reduction in activity level. It is rare to organise imaging beyond x-rays however in this setting due to the concern of his parents and MRI scan was ordered. In most situations where there is a clear relationship of the pain to activity and an improvement with rest and there is localised pain and tenderness in the region of the tibial tubercle observation and the management of load is typically effective. In this situation the player’s symptoms resolved spontaneously over a six month period with an initial reduction in his activity level of about 50%.

Important notice
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BangouraMark FulcherMOTURI ANYONA FELIXCesar Recent comment authors
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Bangoura
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Le syndrome d osgood schlatters est une affection du GENOU c est une apophytose aussi appelée Osteochondrose tibialeriviale antérieure C est une souffrance au niveau de l insertion basse du tendon rotulien vers la tuberosite tibiale anterieure chez les jeunes sportifs de 10 a 16 ans c est un troble de la croissance osseuse assez freqent et benin c est aussi un surmenage mécanique des zones de croissance de l enfant et fé l zdolescent Le syndrome d osgood schlatters se manifeste par une douleur de la face ANTÉRIEURE DU GENOU il concerne les jeunes sportifs dont les actions mécaniques… Read more »

MOTURI ANYONA FELIX
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MOTURI ANYONA FELIX

this is a good discussion
but i have have a question , if an x-ray image was ordered while the knee has weight will it display the same results as the MRI ?

Mark Fulcher
Member

The x-ray is generally normal in this condition. In general terms it is a clinical diagnosis (based on the patients description and examination findings) rather than a radiological one (what x-rays or scans show). I generally see patients who have had symptoms for a number o months. As a result I usually obtain an x-ray. This is more to rule out other things than because I am diagnosing Osgood-Schlatters. MRI scans are generally not needed.

César Crispín Morales García
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César Crispín Morales García

I think x-rays are enough but if you have access to MRI, it never hurts.

Mark Fulcher
Member

In this case the MRI was more to manage the parental concern – rather than for any clinical indication. It was interesting to see the findings though.

Ahmed Mostafa
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Ahmed Mostafa

it’s an amazing discussion