Osgood-Schlatter On Knee X-Ray And MRI

Osgood-Schlatter disease is a common cause of pain around the knee in children who are active in sports.  This is a clinical diagnosis but X-rays and MRI exams can sometimes be done to help with the diagnosis and to exclude other causes.  Treatment is most commonly conservative.

What is Osgood-Schlatter?

Osgood-Schlatter is a chronic stress or overuse injury below the knee joint to the growth center in the tibia.

Osgood-Schlatter occurs where the patellar tendon attaches to the tibia bone.  This is called the tibial tubercle and is a growth center of the bone.  The growth center is made of cartilage while the child is growing and is more susceptible to injuries.

Activities that put stress on the knee can result in irritation of this growth center and symptoms of pain and swelling.

Symptoms of Osgood-Schlatter

There is usually pain and swelling below the knee cap.  The symptoms become worse with activities.  Osgood-Schlatter can happen in one or both knees.

How is Osgood-Schlatter diagnosed?

This is often a clinical diagnosis.  This means your doctor makes the diagnosis by taking a history and examining the child.  X-rays and MRI are ordered in some cases to confirm the diagnosis and rule out other causes.

What does Osgood-Schlatter look like on knee X-ray?

Knee X-rays may show soft tissue swelling and bone fragmentation at the tibial tubercle below the knee cap.

What does Osgood-Schlatter look like on MRI?

We will often see swelling and bone fragmentation at the tibial tubercle below the knee cap. There may be edema in the tibial tubercle or growth center.   There may be a thickened patellar tendon at its attachment on the tibial tubercle and signs of bursitis.

What else can look like Osgood —Schlatter in radiology?

Jumpers knee is a chronic injury to the patellar tendon as it attaches to the lower part of the patella (knee cap).  The patellar tendon will be thickened and partially torn. This can cause similar symptoms to Osgood Schlatter but the site of injury is different as is the imaging appearance.

Infrapatellar bursitis is a collection of fluid in a bursa.  A bursa is a fluid filled sac that allows smoother motion between parts in your joint.  Infrapatellar bursitis can be located around the patellar tendon near the tibial tubercle.  This condition does not involve the tibial tubercle itself but can cause similar symptoms.

Sinding-Larsen-Johansson disease is similar to Osgood-Schlatter except this occurs at the lower patella growth center instead of the tibial tubercle.

What causes Osgood-Schlatter?

This is caused by a chronic stress or overuse injury of the tibial tubercle or growth center.  This is caused by the patellar tendon pulling on the tibial tubercle and causing a chronic injury with inflammation.

Is Osgood-Schlatter dangerous?

This condition is usually not dangerous and will resolve with conservative trestment.

What type of doctor treats Osgood -Schlatter?

This condition can be treated by both primary and specialty physicians like orthopedics.

Osgood-Schlatter treatment

Treeatment is usually conservative.  Rest or discontinuing athletic activities may be required until the pain subsides.  Icing the knee and pain medications may help with symptoms.  Stretching exercises and physical therapy are required for some.  Surgery is rarely needed.  The pain will usually go away when the child stops growing.

Osgood-Schlatter: summary

Osgood-Schlatter represents an inflamed tibial tubercle or growth center from overuse and chronic injury.  The diagnosis is a clinical one, however knee X-rays and MRIs are sometimes ordered.  Osgood-Schlatter is treated conservatively and will usually resolve as the child stops growing.