Osgood schlatter disease is a condition in orthopedics in which there is inflammation of patellar ligament at the level of tibial tuberosity which can also present as avulsion of a bone fragment at the tibial tuberosity.(1) The ligament is a stretchable tissue that joins bones on both sides. The patellar ligament is the ligament arising from patellar bone and inserts at tibial tuberosity on the anterior aspect of the tibia. It gets inflamed or avulsed due to repeated pulling by the quadriceps muscles which are specially used during running and jumping. It is commonly seen in children and adolescents. The age ranges from 8 to 15 years but can be rarely found even later. It affects males more than females.(2)
Does Osgood Schlatter Show Up On X-Ray?
The patients usually present with the chief complaint of pain in the knee region and the preliminary investigation for osgood schlatter disease is X-ray. Usually, the X-ray of osgood schlatter disease is normal without any fracture because the ligament inflammation and ligament itself cannot be appreciated on the X-ray as they are radio transparent. But sometimes X-ray of osgood schlatter disease can also present with a fracture at the tibial tuberosity if the condition is moderate. The type of fracture can be used to distinguish between moderate and severe injuries.
According to the classification, there can be three types of fractures at the tibial tuberosity in Osgood schlatter disease. Type 1 fracture is when only a small fragment of the bone is avulsed proximally but the articular surface may or may not be damaged. Type II fracture is when there is an intact articular surface of the tibia but the fracture line extends in between proximal tibial epiphysis and the secondary ossification center of the tibia. Type III fracture is described as complete avulsion of the patellar ligament from the tibia along with the damage to the articular surface also. It may or may not be associated with meniscal injury.(3)
The treatment of Osgood schlatter disease is based upon the severity of the condition. There may not be any medical or surgical treatment required in most of the cases because it is a self-limiting condition that improves with rest. Certain exercises and movements need to be restricted to control the damage like running, jumping, squatting, lifting things from the ground, walking upstairs and downstairs frequently, etc.
Is Swimming Good For Osgood Schlatter?
Less stressful activities are recommended to give time for the healing as well as reduce further damage to the site like swimming, normal walking, etc. These also help to maintain some sort of physiotherapeutic movements which are very helpful in this condition. Swimming is a good activity with lesser input from the quadriceps muscles and can be suggested in Osgood schlatter disease.
Osgood schlatter disease is an inflammatory condition of the patellar ligament at its distal-most end. Inflammation is a radio transparent phenomenon which is not seen upon the X-ray because of limited exposure. It can be well appreciated on magnetic resonance imaging (MRI) because it is the best investigation to see for a bony inflammation. If there is avulsion of the bone fragment along with the patellar ligament or complete disruption of the insertion point of patellar ligament then it can be appreciated on an x-ray. But even still only the fracture is seen and no inflammatory changes can be seen on the X-ray.
Stressful activities like jumping, running are the main causes of this condition and to be avoided to prevent further worsening of the condition. Light activities like walking or heavy activities involving the least effort of gravity such as swimming should be suggested. But the most important part is seeking medical help immediately in such a condition.
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