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OSGOOD-SCHLATTER DISEASE - Coggle Diagram
OSGOOD-SCHLATTER DISEASE
Diagnosis
Associated features - trauma, systemic symptoms e.g. fever, weight loss/sweats. Bone /joint pain, night pain, pain after rest/referred pain . If serious alternative cause refer urgently for specialist assessment/investigation
Associated pain starts in adolescence - localised to tibial tuberosity. Gradual onset /intermittent pain. Unilateral. Relieved by rest and worse by kneeling/activity
Examination - Tibial tuberosity tenderness. Pain provoked by resisted knee extension. Tightness of quadriceps/hamstrings. Swelling /bony enlargement . Normal passive ROM. Absence of effusion
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Differential Diagnosis
Tumour - severe knee pain persistent at night or rest, associated bone /joint pain, systemic features e.g. weight loss or general malaise
Inflammatory - Arthritis - Juvenile idiopathic arthritis - knee joint alone/multiple joints, pain, swelling and morning stiffness
Referred pain from the hip - Slipped upper femoral epiphysis presents during adolescent growth spurt more frequent in children overweight.
Transient synovitis - Hip pain in systemically well child younger than 10 years age.
Perthes' disease - avascular necrosis of femoral head epiphysis.
Traumatic Knee Injury - Sudden onset, associated with abnormal physical signs. Injuries include; meniscal, collateral/cruciate ligament, stress fractures of patella, tibial tuberosity fracture, prepatellar/infrapatellar bursitis
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Other Causes - Osteochondritis dissecans, patellofemoral pain syndrome, patellar dislocation.
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Risk Factors
Age - common in children undergoing growth spurts, peaking in boys at 12-15 years, girls at 8-12 years of age.
Sporting Activity - running, jumping and repetitive bending of knee
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