Health Promotion and Maintenance Q 60
An adolescent brings a physician’s note to school stating that he is not to participate in sports due to a diagnosis of Osgood-Schlatter disease. Which of the following statements about the disease is correct?
A. The condition was caused by the student's competitive swimming schedule.
B. The student will most likely require surgical intervention.
C. The student experiences pain in the inferior aspect of the knee.
D. The student is trying to avoid participation in physical education.
Correct Answer: C. The student experiences pain in the inferior aspect of the knee.
Osgood-Schlatter disease occurs in adolescents in the rapid growth phase when the infrapatellar ligament of the quadriceps muscle pulls on the tibial tubercle, causing pain and swelling in the inferior aspect of the knee. Osgood-Schlatter disease is commonly caused by activities that require repeated use of the quadriceps, including track and soccer.
Option A: Swimming is not a likely cause. OSD is a traction phenomenon resulting from repetitive quadriceps contraction through the patellar tendon at its insertion upon the skeletally immature tibial tubercle. This occurs in preadolescence during a time when the tibial tubercle is susceptible to strain. The pain associated will be localized to the tibial tubercle and occasionally the patellar tendon itself.
Option B: The condition is usually self-limited, responding to ice, rest, and analgesics. OSD is a self-limiting condition. In a study by Krause et al, 90% of patients treated with conservative care were relieved of all of their symptoms approximately 1 year after the onset of symptoms. [3] After skeletal maturity, patients may continue to have problems kneeling. This typically is due to tenderness over an unfused tibial tubercle ossicle or a bursa that may require resection.
Option D: Continued participation will worsen the condition and the symptoms. The onset of OSD is usually gradual, with patients commonly complaining of pain in the tibial tubercle and/or patellar tendon region after repetitive activities. Typically, running or jumping activities that significantly stress the patellar tendon insertion upon the tibial tubercle aggravate the patient’s symptoms.