Escolar Documentos
Profissional Documentos
Cultura Documentos
Sayantika Dha
Definition
OsgoodSchlatter disease or syndrome (OSD) is an irritation of the patellar ligament at the tibial tuberosity.
Sayantika Dha
(4): 23641.
It was named after two physicians in 1903, Dr. Robert Osgood and Dr. Carl Schlatter. Osgood Schlatters disease is a very common cause of knee pain in children and young athletes. It occurs during the period of rapid growth, due to a combined high level of sporting activity.
It occurs more frequently in boys than in girls, with reports of a male-to-female ratio ranging from 3:1 to as high as 7:1. [1]
Sayantika D
Sayantika Dha
Sayantika Dha
Causes
OSD is thought to be caused by small injuries due to repeated overuse before the area has finished growing.
Some studies report that up to 50% of patients relates a history of precipitating trauma. It is common in adolescents who play soccer, basketball, and volleyball, and who participate in gymnastics. Osgood-Schlatter disease affects more boys than girls.
Sayantika Dha
Pathomechanics
Sayantika Dha
Quadriceps Femoris
Sayantika Dha
Following an adolescent growth spurt, repeated stress from contraction of the quadriceps is transmitted through the patellar tendon to the immature tibial tuberosity. This can cause multiple sub-acute avulsion fractures along with inflammation of the tendon, leading to excess bone growth in the tuberosity and producing a visible lump which can be very painful when hit.
Activities such as kneeling may irritate the tendon further.
Sayantika Dha
Sayantika Dha
Sayantika Dha
If the patellar tendon attaches more proximally and in a broader area to the tibia, this might probably cause OSD.
Burak Demirag.The pathophysiology of Osgood-Schlatter disease: a magnetic resonance investigation. J Pediatr Orthop B. 2004 Nov ;13 (6):379-82.
Sayantika Dha
Anything that puts excessive stress on the insertion of the patellar tendon
Sayantika Dha
Symptoms
o Main symptom - painful swelling over a bump on the tibia o Symptoms occur on one or both legs. o Pain:
o Pain is mild and intermittent initially. o Later stages- the pain is severe and continuous in nature.
o Palpation: The area is tender to pressure, and swelling ranges from mild to very severe. o Function: The pain is worse with acute knee impact.
Sayantika Dha
Painful swelling
Sayantika Dha
Sayantika Dha
o The pain can be reproduced by extending the knee against resistance, stressing the quadriceps, or striking the knee. o Bilateral symptoms are observed in 2030% of patients. o The symptoms usually resolve with treatment but may recur for 1224 months before complete resolution at skeletal maturity, when the tibial epiphysis fuses.
Sayantika Dha
CLASSIFICATION
o Presentation of Osgood-Schlatter Disease was classified into two groups according to X-ray examination, those with and without fragmentation of the tibial tuberosity. o Later Woolfrey and Chandler (1960) classified the radiological changes associated with Osgood-Schlatter disease into 3 types.
Sayantika Dha
o Type I, where the tibial tubercle is prominent and irregular o Type II, where there is additional small fragments of bone adjacent to the anterior and superior aspects o Type III, where the tubercle is normal, but there is free bone particles in similar distribution.
Sayantika Dha
Diagnosis
Radiographs
Sayantika Dha
Sayantika Dha
Sayantika Dha
Differential Diagnosis
SindingLarsenJohansson syndrome
Sayantika Dha
Prevention
The small injuries that may cause this disorder are usually unnoticed, so prevention may not be possible.
Regular stretching, both before and after exercise and athletics, can help prevent injury.
Sayantika Dha
Conservative Management
o Ibuprofen or other nonsteroidal anti inflammatory drugs (NSAIDs),
or acetaminophen (Tylenol).
o Rest (3 days) and decreasing activity (1-2 weeks) o Ice - over the painful area, 2 to 3 times a day, 20 to 30 minutes at a time, o Bracing, Orthopedic casting
Sayantika Dha
Sayantika Dha
Sayantika Dha
Surgical Management
Sayantika Dha
Physiotherapy Management:
Stretching Hamstrings Quadriceps Calf muscles Strengthening SLR Prone Hip extension Knee stabilisation Quadriceps strength training, with terminal range movement
Sayantika Dha
Sayantika Dha
Sayantika Dha
Sayantika Dha
Sayantika Dha
Sayantika Dha
THANK YOU