Diagnosis Of Osgood-Schlatter’s Disease
Osgood-Schlatter’s disease is mainly diagnosed by clinical presentation (the presenting symptoms and physical examination of the child). However, the use of additional tests, such as an x-ray or ultrasound scan, may be used to rule out other possible causes of the symptoms.
The diagnosis of Osgood-Schlatter’s disease can usually be confirmed by x-ray which also may be used to exclude more serious conditions. Typically x-rays will show a small area of separation at the site of insertion of the patella tendon to the tibia if the child has Osgood-Schlatter’s disease (please see our previous blog titled Osgood Schlatter’s Disease: Not Really A Disease for a brief explanation of local anatomy).
Where Does The Osgood-Schlatter’s Disease Bump Come From?
Your quadriceps muscles are joined to the tibial tuberosity by the patella tendon. During bone growth, in Osgood-Schlatter’s disease the point where the tendon attaches to the shin bone becomes inflamed and micro-fractures occur at the bone. The body repairs these fractures by laying down extra bone tissue with the end result of this being a larger than normal bump at the tibial tuberosity.
I Think My Child Has Osgood-Schlatter’s Disease, What Should I Do?
- Taking your child to their GP is a good starting point, they can order any appropriate imaging deemed necessary, offer advice and then refer on accordingly.
- Many parents will take their child straight to see a physiotherapist which is also a good option as frequently imaging is not necessary and the physio can advise if they feel otherwise.
The Management Of Osgood-Schlatter’s Disease
The problem is excessive stress being placed on the growth plate at the insertion of the patella tendon. Children are more prone to this problem when they are going through a growth spurt and the muscle / tendon development verses the growth of the local bone tissue is out of balance.
Symptomatic treatment is the key in managing the condition and painful activities should be avoided during an exacerbation of the condition. Treatment is very much a management thing, the syndrome itself is self limiting and the kid will usually grow out of it. However during the period of an exacerbation the effects of the pain can be quite limiting for sports and activities that the kid most likely loves to participate in. Some techniques and approaches physiotherapists use to help control the pain and aid returning the child back to their normal level of activity are:
- A RICE regime when the knee/s are painful.
- Recognizing the painful triggers and reducing them when necessary. Activity modification or relative rest – completely avoiding activities that are painful for at least a couple of weeks followed by gradual return to activity guided by symptom levels.
- Occasionally it may be necessary to rest the knee in plaster or a splint when the pain is very severe.
- Even more rarely and only when growth has finished if a small loose body remains in the tendon this may need to be surgically removed if symptoms persist.
- Improving the child’s pelvic and core stability as well as their lower limb stability.
- Improving the alignment and lower limb biomechanics
- Muscle stretching of tight structures in and around the lower limb may be beneficial.
- The use of taping or braces in an attempt to take pressure off the painful area.
- Likewise the use of impact orthotics may aid in load transference reducing the forces transmitted to the painful area.
The Prognosis Of Osgood-Schlatter’s Disease
Osgood-Schlatter’s disease is a self limiting syndrome and usually resolves by itself within 12 months. However, with some children the knee may remain uncomfortable until growing finishes. It usually resolves by itself with a period of activity modification, and a combination of the above treatment approaches. Being a self limiting syndrome, the child will grow out of it with little complications however it is still a good idea to see your local physiotherapist to get some help in managing the condition.
Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on Managing Osgood-Schlatter’s Disease should consult his or her general practitioner, physiotherapist or otherwise appropriately skilled practitioner.