Osgood-Schlatter Disease

• Etiology:
  — Repetitive microtrauma from jumping and kicking leads to chronic stress and trauma
  — Chronic traction apophysitis
  — Stress injury of patellar tendon on tibial tubercle
  — Chronic stress of patellar tendon
  — Transition from fibrocartilage to hyaline cartilage
  — Affects anterior portion of tubercle
  — Not physeal
• Imaging Radiograph:
  — Changes in soft tissues are greater than ossification irregularity
  — Early see pre-tibial soft tissue swelling and infiltration of Hoffa’s fat pad and thickening of patellar tendon and suprapatellar joint effusion
  — Later see fragmentation of tibial tuberosity
  — Fragmentation of tibial tubercle does not have to be present
• Imaging MRI:
  — Soft tissue swelling anterior to tibial tubercle
  — Thickening and edema of distal patellar tendon
• DDX: Sindig-Larsen-Johansson disease
• Complications:
• Treatment:
• Clinical:
  — Gradual onset with pain and swelling at tibial tuberosity is how diagnosis is made
  — Seen in 10-15 years old male classically
  — Bilateral in 25-50%

Radiology Cases of Osgood-Schlatter Disease