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Osgood-Schlatter's disease - Management
How do I know my patient has it?

  • Exclude a serious cause for knee pain.
    • Suspect another cause if knee pain:
      • Starts suddenly after trauma to the knee.
      • Is associated with systemic symptoms, including fever, weight loss, or general malaise.
      • Is associated with pain in bones or joints at other sites.
      • Persists at night or after rest.
      • Is associated with an abnormal examination of the hip or knee joint.
    • For information on other causes of knee pain, see Differential diagnosis.
    • If a serious cause is suspected, urgently investigate or refer for specialist assessment to confirm or exclude the diagnosis.
  • Diagnose Osgood–Schlatter's disease on the basis of clinical features alone when:
    • There are no features of another cause for knee pain.
    • Knee pain starts in adolescence and is localized to the tibial tuberosity. Typically, pain is:
      • Unilateral, but may occur bilaterally in up to 30% of people.
      • Gradual in onset.
      • Relieved by rest and made worse by activity, particularly activities that involve running or jumping.
    • Tenderness is present over the tibial tuberosity that is provoked by knee extension against resistance or by hyperflexing the knee with the person lying prone.
    • Firm enlargement of the tibial tuberosity may be present.
  • Routine X-ray examination of the knee is not recommended because it lacks sensitivity to diagnose the condition. If undertaken, the X-ray may be normal or difficult to interpret, or it may demonstrate fragmentation of the tubercle.

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