Osgood-Schlatter Disease
Osgood-Schlatter disease, also known as Lannelongue disease, is a cause of knee pain in patients with immature skeletons. It is an apophysitis, an inflammation in the lower part of the patellar ligament, at the point of its insertion into the tibia. It was first described in 1903 by two authors, who give the condition its name: Robert Bayley Osgood and Carl B. Schlatter.
The disease occurs due to repetitive traction of the patellar ligament at its insertion into the tibia, which is still partially cartilaginous in children and adolescents with an immature skeleton. It is an osteochondritis most common in the lower limbs of children and adolescents who practice sports.
The onset of Osgood-Schlatter disease coincides with the development of the secondary ossification center of the anterior tibial tuberosity, which usually occurs around the age of 9 in girls and 11 in boys. Symptoms usually appear between the ages of 9 and 12 in girls and 12 and 15 in boys.
What does the patient feel?
The main symptom of Osgood-Schlatter disease is pain in the front of the knee, which varies in intensity and increases when the area is pressed. Kneeling or benting the knee can worsen the pain. In addition, swelling at the point where the patellar ligament inserts into the tibia and tenderness in the area may be found. Symptoms may manifest or worsen with sports.
How is the diagnosis made?
The diagnosis of Osgood-Schlatter disease is made, firstly, through a good conversation between the doctor, the patient and the parents. This way, it is possible to know the characteristics related to the discomfort.
A thorough physical examination is also very important, since there are other problems that can cause similar pain, however, in slightly different locations, such as:
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Distal quadriceps tendonitis;
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Prepatellar bursitis;
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Chondromalacia patella;
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Fracture of the patella;
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Fracture of the anterior tibial tuberosity;
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Sinding-Larsen-Johansson syndrome (learn more);
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Superficial and deep infrapatellar bursitis;
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Patellar tendonitis;
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Hoffitis.
Some imaging exams can help when the disease is suspected. They are:
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Knee X-rays;
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Ultrasonography;
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Nuclear magnetic resonance.
Treatment
In most cases, Osgood-Schlatter disease is treated non-operatively. During periods of inflammation, when the patient complains of more intense pain, partial rest may be recommended, with a temporary reduction in sports and exertion. In addition, analgesic and anti-inflammatory medications may be prescribed, such as paracetamol, ibuprofen, among others. It is worth remembering that any medication used must be recommended by a qualified professional.
Since the problem is directly related to repetitive effort, it is common for us to refer patients to physiotherapy, so that the pain improves more quickly and the patient can begin muscle rebalancing work early.
Usually, patients develop a significant improvement in pain after treatment and after the skeleton matures.
Surgical treatment for Osgood-Schlatter disease is rare and is usually reserved for adult patients who end up with a calcification near the insertion spot of the patellar ligament in the tibia, which can cause recurrent tendonitis and tendinopathy.
Strengthening specific muscles according to the sports gestures of patients who practice high-intensity activities is important to try to reduce the overload in the area and prevent the onset of both Osgood-Schlatter disease and other problems that cause pain in the front of the knee.
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