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Assessment of Osgood-Schlatter Disease and the Skeletal Maturation of the Distal Attachment of the Patellar Tendon in Preadolescent Males.

Yanagisawa S, Osawa T, Saito K, Kobayashi T, Tajika T, Yamamoto A, Iizuka H, Takagishi K - Orthop J Sports Med (2014)

Bottom Line: The SLRA was not significantly different among groups.OSD was observed significantly more often in stage E than in the other stages (P < .05).The prevalence of OSD was highest in stage E.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan.

ABSTRACT

Background: Osgood-Schlatter disease (OSD) is a traction apophysitis of the tibial tuberosity. Ultrasonography (US) is able to detect pathologic changes, such as cartilage swelling and fragmentation of the tibial tubercle ossification center.

Purpose: To compare the US stages of tibial tuberosity development and the physical features and prevalence of OSD in this patient cohort.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: Subjects included 238 males (n = 476 joints) with a mean age of 11.4 ± 1.6 years (range, 7-14 years). The tibial tuberosity development on US was divided into 3 stages: the cartilaginous stage (stage C), apophyseal stage (stage A), and epiphyseal stage (stage E). It was then investigated whether the subjects had pain in the tibial tuberosity on application of pressure. Age, height, body weight, body mass index (BMI), heel-buttock distance (HBD, cm), and straight-leg raise angle (SLRA) were evaluated. To confirm the diagnosis of OSD, the participant had to fulfill the following clinical criteria: pain with direct pressure on the tibial apophysis, fragmentation of the bone, and irregularity of the ossification center detected by US.

Results: The tibial tuberosity was stage C in 195 knees, stage A in 105 knees, and stage E in 176 knees. The subjects' heights, weights, and BMIs significantly increased with advancing development of the tibial tuberosity. The HBD increased in stage E (P < .01). The SLRA was not significantly different among groups. There was fragmentation of the bone and irregularity of the ossification center in 32 knees (6.8%): 0 in stage C, 21 (4.3%) in stage A, and 11 (2.3%) in stage E. Fragmentation of the bone and irregularity were observed significantly more often in stage A (P < .01). On the other hand, there were 10 joints with OSD (2.1%): 0 in stage C, 3 (0.6%) in stage A, and 7 (1.5%) in stage E. OSD was observed significantly more often in stage E than in the other stages (P < .05).

Conclusion: The present study showed that the HBD increased from stage A to stage E. The prevalence of OSD was highest in stage E.

No MeSH data available.


Related in: MedlinePlus

Ultrasound images of knees that are representative of the 3 stages of the maturation process of the patellar tendon attachment. (A) Stage C, (B) stage A, and (C) stage E. A, apophyseal cartilage.
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fig1-2325967114542084: Ultrasound images of knees that are representative of the 3 stages of the maturation process of the patellar tendon attachment. (A) Stage C, (B) stage A, and (C) stage E. A, apophyseal cartilage.

Mentions: Preparticipation physical examinations were conducted on preadolescent baseball players. The subjects were 238 males (n = 476 joints) who were baseball players, with a mean age of 11.4 years (range, 7-14 years). The skeletal maturation of the distal attachment of the patellar tendon was examined using a LOGIQ e instrument (GE Health Care) with high-resolution linear-array probes at 12 MHz. The US evaluations were performed with both knees in 90° of flexion in the supine position. The tibial tuberosity was examined on longitudinal US images at the site at which the tuberosity was most clearly visualized. The tibial tuberosity development on US was divided into 3 stages: the cartilaginous stage (stage C) was characterized by a large amount of apophyseal cartilage (anechoic) (Figure 1A), the apophyseal stage (stage A) was characterized by apophyseal cartilage (Figure 1B), and the epiphyseal stage (stage E) was characterized by no detectable sign of apophyseal cartilage (Figure 1C).


Assessment of Osgood-Schlatter Disease and the Skeletal Maturation of the Distal Attachment of the Patellar Tendon in Preadolescent Males.

Yanagisawa S, Osawa T, Saito K, Kobayashi T, Tajika T, Yamamoto A, Iizuka H, Takagishi K - Orthop J Sports Med (2014)

Ultrasound images of knees that are representative of the 3 stages of the maturation process of the patellar tendon attachment. (A) Stage C, (B) stage A, and (C) stage E. A, apophyseal cartilage.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4588527&req=5

fig1-2325967114542084: Ultrasound images of knees that are representative of the 3 stages of the maturation process of the patellar tendon attachment. (A) Stage C, (B) stage A, and (C) stage E. A, apophyseal cartilage.
Mentions: Preparticipation physical examinations were conducted on preadolescent baseball players. The subjects were 238 males (n = 476 joints) who were baseball players, with a mean age of 11.4 years (range, 7-14 years). The skeletal maturation of the distal attachment of the patellar tendon was examined using a LOGIQ e instrument (GE Health Care) with high-resolution linear-array probes at 12 MHz. The US evaluations were performed with both knees in 90° of flexion in the supine position. The tibial tuberosity was examined on longitudinal US images at the site at which the tuberosity was most clearly visualized. The tibial tuberosity development on US was divided into 3 stages: the cartilaginous stage (stage C) was characterized by a large amount of apophyseal cartilage (anechoic) (Figure 1A), the apophyseal stage (stage A) was characterized by apophyseal cartilage (Figure 1B), and the epiphyseal stage (stage E) was characterized by no detectable sign of apophyseal cartilage (Figure 1C).

Bottom Line: The SLRA was not significantly different among groups.OSD was observed significantly more often in stage E than in the other stages (P < .05).The prevalence of OSD was highest in stage E.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan.

ABSTRACT

Background: Osgood-Schlatter disease (OSD) is a traction apophysitis of the tibial tuberosity. Ultrasonography (US) is able to detect pathologic changes, such as cartilage swelling and fragmentation of the tibial tubercle ossification center.

Purpose: To compare the US stages of tibial tuberosity development and the physical features and prevalence of OSD in this patient cohort.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: Subjects included 238 males (n = 476 joints) with a mean age of 11.4 ± 1.6 years (range, 7-14 years). The tibial tuberosity development on US was divided into 3 stages: the cartilaginous stage (stage C), apophyseal stage (stage A), and epiphyseal stage (stage E). It was then investigated whether the subjects had pain in the tibial tuberosity on application of pressure. Age, height, body weight, body mass index (BMI), heel-buttock distance (HBD, cm), and straight-leg raise angle (SLRA) were evaluated. To confirm the diagnosis of OSD, the participant had to fulfill the following clinical criteria: pain with direct pressure on the tibial apophysis, fragmentation of the bone, and irregularity of the ossification center detected by US.

Results: The tibial tuberosity was stage C in 195 knees, stage A in 105 knees, and stage E in 176 knees. The subjects' heights, weights, and BMIs significantly increased with advancing development of the tibial tuberosity. The HBD increased in stage E (P < .01). The SLRA was not significantly different among groups. There was fragmentation of the bone and irregularity of the ossification center in 32 knees (6.8%): 0 in stage C, 21 (4.3%) in stage A, and 11 (2.3%) in stage E. Fragmentation of the bone and irregularity were observed significantly more often in stage A (P < .01). On the other hand, there were 10 joints with OSD (2.1%): 0 in stage C, 3 (0.6%) in stage A, and 7 (1.5%) in stage E. OSD was observed significantly more often in stage E than in the other stages (P < .05).

Conclusion: The present study showed that the HBD increased from stage A to stage E. The prevalence of OSD was highest in stage E.

No MeSH data available.


Related in: MedlinePlus