Pictorial case study: Osgood-Schlatter's disease

A 14-year-old boy presented with his mother. He had noticed pain below his right knee for a few weeks and more recently a tender swelling. He was a very keen sportsman and was otherwise well.

 

On examination, there was a very prominent tender lump over the upper tibia which was tender to touch. Knee examination was normal and movements were full and pain-free. What is the diagnosis, management and differential diagnoses?

Diagnosis and management

The diagnosis is Osgood-Schlatter’s disease or traction apophysitis of the tibial tuberosity. It is an overuse condition affecting young teenagers (mainly boys) and is uncommon over 16 years. It is most common in those who frequently play sports.

The diagnosis is clinical and no diagnostic tests are needed. It usually resolves in a few months with rest. Analgesia may be required in some cases. If the problem persists, refer for physiotherapy. If it persists for two years or more, then refer for the knee to be immobilised in a plaster cast.

Possible different diagnoses

Avulsion of the tibial tubercle.

Jumper’s knee.

Sindig-Larsen-Johanssen disease.

Differential diagnosis

Avulsion of the tibial tubercle

More common in 12–16-year-olds.

Swelling, pain and tenderness over the tuberosity.

Compartment syndrome may occur.

Contributed by Dr Gwen Lewis, a GP in Windsor, Berkshire

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

Woman holding face in pain

Should GPs treat patients presenting with dental problems?

The MDU's Dr Kathryn Leask considers what GPs should do if a patient presents with...

Conservative Party leadership candidate and foreign secretary Liz Truss

Liz Truss vows to resolve GP pension tax crisis if she becomes prime minister

Liz Truss has affirmed her commitment to resolving the GP pensions crisis but has...

Baby receiving a vaccine in their thigh

JCVI advises changes to routine childhood and HPV immunisation schedules

The Joint Committee on Vaccination and Immunisation (JCVI) has recommended a change...

GP consultation

General practice delivering 'up to double the appointments it is paid for'

General practice in England may be delivering as many as double the number of appointments...

Sign outside BMA House

GP suicide sparks calls for measures to protect doctors from spiralling workloads

The government and policymakers must do more to safeguard doctors and NHS staff from...

Talking General Practice logo

Podcast: Living with long COVID

In August we’re bringing you some of the best interviews from series one of the podcast....