Diagnosing Osgood-Schlatter Disease

NYU Langone pediatric orthopedists provide expert diagnosis of Osgood-Schlatter disease, an overuse injury and common source of knee pain in active children and adolescents.

Osgood-Schlatter disease is caused by inflammation in the area below the knee, where the tendon from the kneecap, called the patellar tendon, attaches to the shinbone, or tibia. This inflammation causes pain and swelling at the bump on the upper part of the tibia, called the tibial tubercle.

The condition often develops in kids and teens who participate in sports that involve a lot of running, twisting, or jumping, such as basketball, gymnastics, and soccer. However, children who are less active may also experience it.

Osgood-Schlatter disease typically occurs in boys 11 to 14 years old and in girls 9 to 12 years old. The condition tends to coincide with growth spurts, which are periods when a child’s bones, muscles, and tendons change rapidly but not always at the same rate. During growth spurts the growth plate is weaker and more likely to widen with the patellar tendon pulling in this area. Growth plates are bands of soft cartilage near the ends of bones where new bone forms as children and teens grow.

Sometimes, as a child exercises, differences in the size and strength of muscle groups stress the growth plate at the top of the tibia, leading to inflammation and pain. 

As a child matures, the growth plates eventually “close,” meaning they harden and turn into bone. When growth plates are “open,” these fragile areas can fracture. They are often weaker than surrounding bone and tissues and are a common area of injury in active children and teens.

Symptoms of Osgood-Schlatter disease include pain, swelling, and tenderness at the tibial tubercle. A child may also walk with a limp due to pain in the affected knee. 

The pain often occurs when a child is active and subsides with rest. Sometimes the muscles in the front of the thigh, called the quadriceps, and the muscles in the back of the thigh, called the hamstrings, are tight and put pressure on the tibial tubercle.

The condition usually resolves on its own after a child’s bones stop growing.

If your child frequently complains of knee pain when he or she is active or plays sports, our specialists can conduct a comprehensive physical exam and may recommend imaging tests to diagnose the condition.

Physical Examination

An NYU Langone doctor asks about your child’s symptoms and health and thoroughly examines the knee to determine the cause of the pain. This includes applying pressure to the tibial tubercle, which is often tender or painful in children with Osgood-Schlatter disease.

The doctor also assesses any swelling and asks about the type and severity of pain your child is experiencing. Your child may be asked to walk, run, jump, or kneel to determine if certain movements cause or worsen the pain.

X-rays

Your child’s doctor may use X-rays to get a closer look at the knee. These can sometimes show changes at the tibial tubercle but mainly help in ruling out other conditions.