Osgood-Schlatter Disease - Diagnosis and treatment

Imaging Studies:Knee radiograph is important to exclude other diagnoses such as malignancy, tibial fracture and infection. Note osiculi in shallow patellar tendon. Irregular ossification of the proximal tibial tuberosity and patellar tendon calcification, and patellar tendon thickening with soft tissue swelling over the tibial tuberosity are elements that can be described on X-ray.Computed tomography and magnetic resonance imaging are not routinely performed but may be helpful in cases where other pathology is suspected or when a problem can not be detected on radiography. In the active stage of disease can be observed tendon enlargement and reduction of tendon insertion. You can see the superficial infrapatelare scholarships or late in the active phase. A Osica may be visible.Ultrasound can detect the same anatomical abnormalities such as plain radiography, CT and MRI. Distal patellar tendon is thickened and more echogen than normal. There is an area of ​​soft tissue swelling hipoechogenitate around above the tibial tuberosity apophysis.
The differential diagnosis is made with the following conditions: fractures of the tibia and fibula, quadriceps tendon avulsion, patelofemural stress syndrome, bursitis pes anserinus, Chondromalacia patella, proximal tibial osteomyelitis, patellar tendon, Hoffa's syndrome, injury sinoaviale envelopes, tibial tubercle fracture.
Treatment
Conservative therapy includes application of ice for 20 minutes every 2-4 hours. Analgesics and NSAIDs can be administered to relieve symptoms and reduce local inflammation. The patient should avoid activities that cause him pain. Use a knee immobilizer for several days. Once acute symptoms have diminished indicate quadriceps stretching exercises including thigh extension to reduce tension on the tibial tubercle.
Approximately 90% of cases respond well to conservative therapy.Refractory patients can be sent to orthopedic surgery after reaching skeletal maturity. Surgical therapy includes drilling the tibial tubercle, excision of the tibial tubercle, patella tendon longitudinal incision, excision osiculilor disunity and free cartilaginous parts, insertion of bone grafts.