Enfermedad de Osgood-Schlatter / Osgood-Schlatter Disease

Introducción: La enfermedad de Osgood-Schlatter afecta la tuberosidad anterior tibial. Ocasiona dolor e inflamación de la rodilla y un paulatino crecimiento de esta tuberosidad. En los exámenes radiológicos se observó el crecimiento y desprendimiento de la tuberosidad anterior tibial. Objetivo: Valorar la evolución radiológica de la enfermedad de Osgood-Schlatter junto a su evolución clínica desde su aparición en un niño. Caso clínico: Paciente masculino, de 11 años de edad, que acudió al Hospital Nacional Dr. Mario Catarino Rivas por presentar dolor moderado a intenso e inflamación leve en su rodilla izquierda, de varias semanas de evolución, luego de realizar moderada actividad física. En el Rayos X (postero-anterior y lateral) de la rodilla izquierda se observó una leve avulsión de la tuberosidad. Se diagnosticó Osgood-Schlatter. Se prescribió antiinflamatorios no esteroideos y reposo. Actualmente, a sus 14 años, el paciente presenta tumoración prominente de ambas tuberosidades, refiere dolor moderado al ejercitarse y al arrodillarse. Se realizaron Rayos X (vista postero-anterior y lateral) en ambas rodillas con el fin de comparar la evolución de su enfermedad después de tres años del diagnóstico. Se observó mayor avulsión de ambas tuberosidades anteriores tibiales. No hubo modificaciones en su tratamiento, ya que no refirió empeoramiento de los síntomas. Conclusiones: Con un diagnóstico clínico y radiológico se puede observar el progreso y severidad de la enfermedad de Osgood-Schlatter. Esta es benigna y su manejo, principalmente, es conservador(AU)

Introduction: Osgood-Schlatter disease affects the tibial anterior tuberosity. It causes pain and inflammation of the knee and gradual growth of this tuberosity. Radiological examinations showed the growth and detachment of the tibial anterior tuberosity. Objective: To assess the radiological evolution of Osgood-Schlatter disease along with the clinical evolution since the appearance in a child. Case report: An 11 year-old male patient came to Dr. Mario Catarino Rivas National Hospital due to moderate to intense pain and mild inflammation in his left knee, after his moderate physical activity for several weeks. X-rays (postero-anterior and lateral) of his left knee showed a slight avulsion of the tuberosity. Osgood-Schlatter was diagnosed. Nonsteroidal anti-inflammatory and rest was prescribed. Currently, at 14, the patient has prominent tumor of both tuberosities, refering moderate pain when exercising and kneeling. X-rays (postero-anterior and lateral view) were performed on both knees in order to compare the evolution of the disease after three years of diagnosis. Greater avulsion of both tibial anterior tuberosities was observed. There were no modifications in the treatment, since he did not report worsening of symptoms. Conclusions: The progress and severity of Osgood-Schlatter disease can be observed with a clinical and radiological diagnosis. This disease is benign and its management is mainly conservative(AU)

Introduction: La maladie d'Osgood-Schlatter affecte la tubérosité tibiale antérieure (TTA). Cette affection provoque la douleur et l'inflammation du genou, et une croissance progressive de cette tubérosité. Les examens radiologiques ont permis de visualiser la croissance et l'arrachement de la tubérosité tibiale antérieure. Objectif: Évaluer l'évolution clinique et radiologique de la maladie d'Osgood-Schlatter depuis sa survenue chez un enfant. Cas clinique: Il s'agit d'un patient âgé de 11 ans qui s'est rendu à l'Hôpital National Dr Mario Catarino Rivas due à une douleur modérée à intense et une légère inflammation au niveau du genou gauche, d'une durée de quelques semaines, après activité physique modérée. Une légère avulsion de la tubérosité a été observée sur les clichés du genou gauche (vue antéro-postérieure et vue latérale). Il a été diagnostiqué de la maladie d'Osgood-Schlatter, et on lui a prescrit des anti-inflammatoires non stéroïdiens (AINS) et du repos. Aujourd'hui, à l'âgé de 14 ans, le patient est atteint d'une tumeur proéminente au niveau de toutes les deux tubérosités; il se plaint d'une douleur modérée lorsqu'il fait des sports ou se met à genoux. Tous les deux genoux sont examinés au moyen des rayons X (vue antéro-postérieure et vue latérale), afin de comparer l'évolution de sa maladie trois ans après le diagnostic. On a trouvé une avulsion beaucoup plus grande au niveau de toutes les deux tubérosités. Le traitement n'a pas été modifié, car il n'y a pas eu d'aggravation des symptômes. Conclusions: Grâce aux diagnostics clinique et radiographique, on peut observer le progrès et la sévérité de la maladie d'Osgood-Schlatter. Cette affection est bénigne, et son traitement est essentiellement conservateur(AU)

Clinics in diagnostic imaging (202). Osgood-Schlatter disease (OSD)

A 14-year-old boy presented with left anterior knee pain, which was aggravated by exercise and relieved by rest. On clinical examination, there was tenderness at the tibial tuberosity with reproducible pain on resisted active extension of the knee. Radiographs showed heterotopic ossification of the patellar tendon with irregularity and fragmentation of the tibial tubercle. Clinical and radiological findings were consistent with Osgood-Schlatter disease, which is a traction apophysitis of the tibial tubercle commonly occurring in adolescents. The clinical presentation and imaging features are discussed.

Enfermedad de Osgood-Schlatter en un adolescente deportista: Caso clínico / Osgood-Schlatter disease in adolescent athlete: Case report

El dolor de rodilla es uno de los síntomas musculoesqueléticos más frecuentes en jóvenes físicamente activos y aparece, sobre todo, en adolescentes varones. Dentro del diagnóstico diferencial, hay que considerar entidades habituales de diagnóstico clínico, como la osteocondrosis apofisaria, y también otras en las que se precisan estudios complementarios. Se presenta el caso de un varón deportista de 12 años con dolor continuo en la rodilla derecha que se intensificaba con la actividad física y la presión directa. Se hizo el diagnóstico de enfermedad de Osgood-Schlatter mediante los datos exploratorios, reproducción del dolor ante la palpación a punta de dedo sobre la tuberosidad tibial anterior, y se confirmó mediante radiología. Se describe esta entidad y otras derivadas de la sobreutilización en la actividad física con las que hacer diagnóstico diferencial; se insiste en las medidas preventivas en cuanto a una correcta orientación en la actividad deportiva.

Knee pain is one of the most frequent musculoskeletal symptoms in young physically active males. Common entities of clinical diagnosis as osteochondritis/apophysitis and others that need complementary studies should be considered in the differential diagnosis. We present the case of a 12-year-old male athlete with continuous pain in his right knee that intensifies with physical activity and with direct pressure. Diagnosis of Osgood-Schlatter disease is made by exploratory data, pain-to-finger palpation on the anterior tibial tuberosity, and is confirmed by radiology. This entity is described as well as the main pathologies derived from overuse to make differential diagnosis and to stress preventive measures regarding a correct orientation in the sport activity.

Characteristics of pre-existing physical factors associated with the onset of Osgood–Schlatter disease in junior soccer players / 体力科学

The aim of this study is to investigate the characteristics of pre-existing physical factors associated with the onset of Osgood-Schlatter disease (OSD) in junior soccer players. Fifty-nine junior soccer players of the elementary school were included in this study. The boys who had been diagnosed as OSD were excluded. At the time of the first investigation, the subjects were examined through physical evaluation and an ultrasonography. The subjects were followed up one and a half years, and the tibial tuberosity was classified according to the growth stages using the ultrasonography. After the end of follow-up period, the subjects were divided into two groups, those with signs and symptoms of OSD that appeared during the follow up period and those without that. The Mann-Whitney U test was used for the comparison between OSD group’s and control group’s initial assessments. The players who were followed up for one and half years were 38 people. 5 knees of the 4 players were clinically diagnosed as OSD (OSD group), and the remaining 34 players with no symptoms of the OSD constituted the control group. The range of the bilateral hip external rotation, straight leg raise of the non-dominant side, and knee flexion in the OSD group were significantly lower than those in the control group (p < 0.05). We concluded that a decrease in specific joint flexibility might be related with the onset of OSD.

Correlation between Magnetic Resonance Imaging Characteristics of the Patellar Tendon and Clinical Scores in Osgood-Schlatter Disease

PURPOSE: This study aims to evaluate magnetic resonance imaging (MRI) findings in young adults with symptomatic Osgood-Schlatter disease (OSD) and compare those in young adults without OSD. MATERIALS AND METHODS: We compared MRI findings between young adults with OSD (OS group, n=30) and the equivalent number of young adults without OSD (control group). Visual analog scale scores and Kujala scores were evaluated and correlation analysis was performed in the OS group. RESULTS: In the OS group, MRI revealed that the patellar tendon was attached to the tibia more widely, resulting in a reduced free tendon portion, and more proximally to the articular surface (p<0.001). The correlation analysis between MRI findings and clinical scores showed statistically significant correlations (p<0.01). In the OS group, 43% presented with patellar tendinopathy or bone marrow edema at the distal attachments. CONCLUSIONS: Compared to the control group, the relatively small free portion and relatively proximal attachment of the patellar tendon were observed with MRI in the OS group. The free portion of the patellar tendon was positively correlated with the clinical scores. Patellar tendinopathy was also frequently encountered in the OS group.

CT and MRI diagnosis of Osgood-Schlatter disease / 实用放射学杂志

Objective To characterize the CT and MRI features of Osgood-Schlatter disease (OSD),and explore the feasibility of staging OSD by using CT and MRI.Methods The imaging data of the 27 cases with OSD were retrospectively analyzed,and fea-tures of MRI and CT were characterized.Results All 27 cases with OSD were featured with different extent of edema within the pa-tellar tendon.The portion already exhibited edema in the secondary ossification center in 5 cases,which showed high signal intensity on the T2 WI.There were 1 5 cases which exhibited ossified or tears in the secondary ossification center,and 5 of them were featured with opened shell-like separation on sagittal radiograph.Seven cases had isolated solitary ossicles located at the lower part of the pa-tellar ligament,which is also thickening.Among the 7 cases,one showed hypertrophy in the tibial tuberosity.Three cases examined with CT scan,exhibited ossified nodules located at the lower part of the patellar ligament.Conclusion OSD has characteristic CT and MRI features,and MRI scan is an important imaging method to show edema and morphological changes of patellar tendon in OSD,which could help to identify the stage of OSD and predict the prognosis.

A Time-Series Change of Pain for Before and After Surgery for Osgood-Schlatter Disease / The Japanese Journal of Rehabilitation Medicine

Generally, conservative treatment is performed at the initial stage of Osgood-Schlatter disease (OSD) to decrease pain. When this conservative treatment is no longer effective, surgery will be performed to decrease OSD pain by removing a tibial tuberosity avulsed bone and a synovial capsule. We reported a time-series change of pain before and after the OSD surgery on a wrestling athlete. The present subject was a 20-year-old male wrestler (height 183 cm ; weight 90 kg), who received OSD surgery on the left knee. Numerical rating scale (NRS) was used to determine pain before and after the OSD surgery. NRS was measured by three positions : resting position (RP), sitting with knee extending position (SKEP), squat with knee flexing 90° position (SK 90 P) and pressure pain (PP). Immediately after the OSD surgery, NRS at the RP, SKEP, SK 90 P, and PP decreased from NRS 3 to NRS 0, NRS 5 to NRS 1, NRS 8 to NRS 6, and NRS 8 to NRS 1, respectively. Three weeks after the OSD surgery, pain at the SKEP and PP decreased to NRS 0. Eight and eleven weeks after the OSD surgery, pain at the SK 90 P decreased to NRS 2 and NRS 1, respectively. The present case study suggests that OSD surgery may progressively decrease pain. Further studies are needed to clarify the effect of OSD surgery on pain.

The relationship between the flexibility of the quadriceps femoris and the period from onset of the osgood-schlatter disease / Монголын Анагаах Ухаан

Purpose: The purpose of this study was to determine the relationship between the flexibility of the quadriceps femoris and the period from onset of the Osgood-Schlatter disease. Subjects: 45 patients (66 lower limbs) with Osgood-Schlatter disease participated in this study. Methods: Subjects were classified into acute-phase group (pain occurred within one month, 23 subjects, 32 lower limbs) and chronic-phase group (pain occurred over one month, 22 subjects, 34 lower limbs). As a measure of muscle flexibility of the quadriceps femoris, Heel-Buttock distance (HBD) were measured in all participants. Results: The flexibility of the quadriceps femoris within the chronic-phase group was significantly reduced flexibility (10.2 ± 6.5 cm) than in acute-phase group (4.6 ± 5.9 cm; p < 0.001). Conclusion: Patients of the OSD, even if not found a decrease in muscle flexibility of the quadriceps femoris during the acute phase, may be decrease the flexibility as time passes. Prevent the worse symptoms of OSD, it would be effective to introduce stretching from acute phase irrespective reduced flexibility in the physical therapy treatment plan.

The Significance of Bone Scan and Classificationin Young Adult Osgood-Schlatter Disease

PURPOSE: We retrospectively classified the young adult Osgood-Schlatter disease by plain radiography and accessed the relationship between bone scan results and symptom duration. MATERIALS AND METHODS: From 2004 to 2007, young adults with symptoms of Osgood-Schlatter disease were included in the study. The patients were classified into 3 groups, protrusion, cleft and ossicle, according to their radiographic results. All patients had bone scan exams, we analyzed the correlation between the bone scan results and the duration of symptoms. RESULTS: All patients were male with average age of 19.8 (18.5~22.0) years old. Out of 59 patients, 27 were bilateral. Of 86 knee joints, 36 came out positive with bone scan. Positive bone scan rate was 11.1% in protrusion type, 40.0% in cleft type and 61.4% in ossicle type. The pain persisted longer in ossicle type than the others. The symptom duration correlated with the bone scan results. CONCLUSION: We classified young adult Osgood Schlatter disease as three types. The ossicle type of Osgood-Schlatter disease has longer symptom duration, which correlates with the bone scan results. The bone scan result can be one of reliable reference factors for the treatment of young adult Osgood-Schlatter disease.

Paraarticular Chondroma of the Knee: A Case Report / 대한정형외과학회잡지

Paraarticular chondroma of the knee is a very rare benign tumor that seems to develop from cartilageous metaplasia. This lesion should be differentiated from calcifying soft tissue lesions like tumoral calcinosis, and cartilageous lesions like chondrosarcoma and synovial chondromatosis. We experienced a case of paraarticular chondroma of the knee in an Osgood-Schlatter disease patient.