Differential Diagnosis

  • Chondromalacia patellae
  • Infectious apophysitis
  • Osgood-Schlatter disease
  • Patellar tendon avulsion/rupture
  • Sinding-Larson-Johansson syndrome

Diagnosis

  • This patient was diagnosed with Osgood-Schlatter disease, which is seen in active adolescents—especially those who engage in pursuits that entail jumping and kicking
  • Diagnosis is clinical and can be achieved without imaging; however, plain radiographs can be obtained to rule out other etiologies
  • In advanced disease, images may show radiodense fragments or ossicles separated from the tibial tuberosity

 

Learnings/What to Look for

  • Osgood-Schlatter is bilateral in 25% to 50% of patients
  • Age of onset may be slightly earlier in girls (8–12 years of age) than in boys (10–15 years of age)

 

Pearls for Urgent Care Management and Consideration for Transfer

  • First-line treatment for Osgood-Schlatter disease is conservative and nonsurgical. It includes:
    • Ice treatment for 20 minutes every 2 to 4 hours
    • Analgesics and nonsteroidal anti-inflammatory drugs for pain and inflammation
  • Longer-term treatment approaches include:
    • Reducing physical activities that increase symptoms
    • Exercises to strengthen the quadriceps and hamstrings

 

Acknowledgement: Images and case provided by Teleradiology Specialists, www.teleradiologyspecialists.com.

 

 

A 12-Year-Old Male with a 6-Month History of Knee Pain and Swelling
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