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.
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.
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%.
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