Dr. Ebraheim’s educational animated video describes the condition of Osgood Schlatter disease.
An apophysis is found where major tendons and ligaments attach to bone. The tibial tubercle is an apophysis and is an insertion for the patellar tendon. The tibial tubercle apophysis is a secondary ossification center. It is not part of the knee joint and it is subjected to traction stress.
Tibial tubercle ossification: below 11 years of age, the tibial tubercle is cartilaginous. Between 11-14 years of age, the apophysis is formed. Between 14-18 years of age the apophysis fuses with the tibial epiphysis. More that 18 years of age, the epiphysis and apophysis fuse with the rest of the tibia.
Osgood Schlatter disease is a traction apophysitis of the tibial tubercle resulting from repetitive microtrauma. It is an overuse syndrome that results in inflammation of the insertion of the patellar tendon on the tibial tubercle. Osgood Schlatter disease is more common in boys between the age of 12-15 years. The condition is less common in girls and it occurs between the ages of 8-12 years in girls. It is bilateral in about 20% of the cases.
Risk factors: sports aggravate the condition like in jumpers, soccer and sprinters.
Presentation: pain, swelling and tenderness localized over the tubercle on the anterior aspect of the knee. Tibial tubercle may appear enlarged. The pain is increased with physical activity and sports. If unilateral, rule out infection, trauma, tumor and check lateral x-ray for fragmentation and irregularity of the tibial tubercle.
Prognosis: it is a self-limiting diseases. It occurs with increased demand on the immature skeleton. It is resolved when the patient stops growing.
Treatment: reduction of activity until it heals. Short period of limited activity may be sufficient. Knee Immobilizer, physiotherapy, hamstring stretching. Do not inject or use steroids. It may cause fatty necrosis and disfigurement of the skin. The condition may become chronic and cause residual pain, swelling and joint tenderness. X-ray. Separate the ossicle over the tubercle (operation of the painful ossicle may be needed)
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Background music provided as a free download from KZitem Audio Library.
Song Title: Every Step
Негізгі бет Osgood Schlatter Disease - Everything You Need To Know - Dr. Nabil Ebraheim
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