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

Radiograph of Osgood-Schlatter disease
Lateral radiograph of the knee shows fragmentation of the tibial tubercle and obscuration of the infrapatellar fat pad.
Radiograph of Osgood-Schlatter disease
AP radiograph of the knee (left) is unremarkable while lateral radiograph (right) shows infiltration and obscuration of the infrapatellar fat pad and fragmentation of the anterior tibial tubercle.