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At a glance

Benign inflammation of the tibial tuberosity characterized by abnormal bone and cartilage formation in the tibia. Clinically, patients may experience pain, swelling, and tenderness of the knee and ankle.

Synonym

Schlatter Disease.

History

Named after American orthopedic surgeon Robert Bayley Osgood and Swiss surgeon Carl B. Schlatter who described the condition independently in 1903.

Incidence

Observed in approximately 20% of athletic adolescents, bilateral in 25 to 50% of affected individuals.

Genetic inheritance

None.

Pathophysiology

Pain is caused by osteochondritis of the tibial tuberosity at the point of insertion of the tendon of the patella or by a small stress fracture. Motions with high angular impulse of knee extension.

Diagnosis

Swelling and tenderness over the tibial tuberosity.

Clinical aspects

Pain over the tibial tuberosity that is exacerbated by running or jumping. Common pain syndrome in growing children and adolescents.

Precautions before anesthesia

No specific precautions. Consider obtaining coagulation profile if the patient is taking anti-inflammatory medication.

Anesthetic considerations

Chronic administration of steroids must be considered and perioperative coverage may be needed. The use of regional anesthesia might be advantageous if feasible.

Pharmacological implications

Patient may be on nonsteroidal anti-inflammatory drug therapy.

Other conditions to be considered

  • Kienboeck Disease: Acquired bone disorder affecting the wrist, particularly the lunate bone following an injury or inflammation. Recurrent pain and stiffness occur in conjunction with thickening, swelling, and tenderness. The range of motion in the wrist is most often limited.

  • Legg-Calvé-Perthes Disease: Rare disease affecting the hip joint. Abnormalities in bone growth early in life may result in permanent deformity of the hip joint several years later.

References

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Itoh  G, Ishii  H, Kato  H,  et al: Risk assessment of the onset of Osgood-Schlatter disease using kinetic analysis of various motions in sports. PLoS One 13: e0190503, 2018.  [PubMed: 29309422]
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Rosenberg  ZS, Kawelblum  M, Cheung  YY,  et al: Osgood-Schlatter lesion: Fracture or tendonitis? Scintigraphic, CT and MR imaging features. Radiology 185:853, 1992.  [PubMed: 1438775]

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