Master Osgood-Schlatter Disease (Tibial Tubercle Apophysitis) with Picmonic for Physician Assistant

An apophysis is the insertion site on a bone for a tendon; it eventually undergoes secondary ossification as a person grows. When overuse occurs, the apophysis of the tibial tubercle where the patellar tendon inserts becomes inflamed, and Osgood-Schlatter disease develops.

Young boys are more at risk for this condition because they are often very active with sports participation. However the condition can occur just as easily in young girls who are also highly active.

Repetitive running and jumping activities place the greatest strain on the apophysis of the tibial tubercle. If proper rest is not obtained between these activities, the condition is more likely to develop.

Repetitive running and jumping activities place the greatest strain on the apophysis of the tibial tubercle. If proper rest is not obtained between these activities, the condition is more likely to develop.

Children who have rapidly grown over a short period of time are more at risk for Osgood-Schlatter disease. Because girls undergo puberty before boys and experience their growth spurt earlier, they will usually develop the condition before boys even if physical activity level is the same.

Osgood-Schlatter disease can be diagnosed clinically based on a good history, so imaging is unnecessary.

Being one of the most common causes of anterior knee pain in young adolescents, Osgood-Schlatter patients typically complain of pain that increases over time, and is exacerbated by knee flexion.

Physical exam and imaging may both demonstrate an enlarged tibial tubercle.

Localized tissue swelling can be seen around the area of the tibial tubercle.

Refraining from the activity that initially caused the condition is essential. Decreasing intensity of physical activity is indicated in both the short-term following injury, and in the long-term for one to two years. However, the patient should still remain physically active to strengthen surrounding muscles.

Non-steroidal anti-inflammatory drugs, or NSAIDs, work by reversibly inhibiting the COX enzymes to decrease localized inflammation. Although they are not known to accelerate healing, they may provide pain relief.

Refraining from the activity that initially caused the condition is essential. Decreasing intensity of physical activity is indicated both short-term following injury, and long-term for one to two years. However, the patient should still remain physically active to strengthen surrounding muscles.

Since the apophysis is a secondary ossification center, the inflammation associated with Osgood-Schlatter disease will self-resolve once ossification of the site occurs.