Paul Benfanti, MD
Hi, I'm Dr. Paul Benfanti from Johns Hopkins All Children's Hospital and Children's Orthopedics and Scoliosis Surgery Associates. Today we are going to talk about Osgood-Schlatter Disease, a very common condition that occurs around the knee in growing children.
Osgood-Schlatter is really not a "disease", it's not contagious or due to an infection. It's the result of increased tension or stress at the growth plate at the top of the leg bone or tibia. The patellar tendon, the tendon that connects the big quadriceps muscle to the leg, attaches to the top of the leg bone over the growth plate. When there is increased tension on the patellar tendon, which can happen during a growth spurt or when playing sports, the growth plate becomes irritated or inflamed. This causes pain and swelling over and a painful bump may develop over the area. It can happen in one or both knees.
Osgood-Schlatter disease is more common in boys than girls. It typically happens in in the early teen or pre-teen years and affects girls earlier because they reach puberty sooner.
Osgood-Schlatter disease is a self-limiting condition. That is, it usually stops on it's own when the child stops growing.
Every child is different and the symptoms can vary in severity. Some children have mild pain only with activities. Others can have significant constant pain that interferes with standing and walking.
Typically the pain and swelling is below the kneecap at the top of the leg bone. It can worsen with activities, especially running, jumping, squatting and kneeling. Many times the child has tight muscles, especially the quadriceps, hip flexors and hamstrings. The pain usually improves with rest.
Treatment is conservative. Surgery is rarely needed and then only after the child is done growing and has persistent pain. Treatment involves modifying the activities as needed. That is, cutting back the frequency, intensity or volume of training, or sometimes taking a complete rest for a short period. Decreasing the inflammation is important. This is done with ice and medicine. Usually ibuprofen (also called motrin or Advil), or naproxen (also called Aleve) are used and can be purchased over the counter. Stretching exercises are also important. This can help decrease the tension on the growth plate. Also, if the knees tend to get bumped, like in wrestling or soccer, kneepads can be worn to protect the area.
Often times the bump on the knee will stay there even after the child is done growing, but usually doesn't cause any problems as an adult.