Osgood-Schlatter disease

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Overview
Osgood-Schlatter disease (also known as tibial tubercle traumatic apophysitis or Louise's knees disease) is an inflammation of the growth plate at the tibial tuberosity. It is one of a group of conditions called Osteochondritis.

The disease is most common in active boys aged 10-15. It most commonly occurs in just one leg but can occur in both at the same time. It is named after the American surgeon Robert Bayley Osgood (1873–1956) and the Swiss surgeon Carl Schlatter (1864–1934), the two people who first described it. It usually self resolves.

Causes
The condition is caused by stress on the tendon that attaches the muscle at the front of the thigh to the tibia. It occurs when, following an adolescent growth spurt, stress from contraction of the quadriceps is transmitted through the patellar tendon to the not yet fully-developed tibial tuberosity. This can cause inflammation and avulsion fracture, and eventually results in bone growth in the tendon, producing a visible lump.

Symptoms
A visible bump around 2cm in diameter will appear at the tibial tubercle and will cause pain during and after high impact activities, and sometimes after lesser activities such as climbing stairs. The disease is generally a benign condition which in most cases will eventually disappear on its own. Symptoms may last for 2-3 years, but will nearly always resolve at the end of the growth spurt, or at the latest when the tibial epiphysis fuses. However, many adults will continue to experience pain when kneeling throughout the rest of their lives.

Treatment
Treatment includes rest, icing and stretching. Analgesics can also help reduce pain. Doctors encourage patients to take a break from any more physical activity that could induce more pain until the pain subsides. Immobilization of the knee by a cast may be required if the problem persists. As a last resort surgery, consisting of the drilling (under anaesthetic) of multiple holes through the epiphyseal plate promotes fusion and relieves the condition.