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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

A longitudinal ultrasound image of the tibial tuberosity. The image shows fragmentation of the bone (arrow).
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fig2-2325967114542084: A longitudinal ultrasound image of the tibial tuberosity. The image shows fragmentation of the bone (arrow).

Mentions: We investigated whether the subjects had pain in the tibial tuberosity on application of pressure. The height was measured with a portable height scale using graduations of 0.1 cm. Weight was measured on an electronic scale. The heel-buttock distance (HBD, cm) was measured in the prone position, and the straight-leg raise angle (SLRA) was evaluated with the participant assuming the supine position and flexing the hip with the knee extended. The straight-leg raise angles were divided into 4 groups at 15° intervals: grade 1 = <60°, grade 2 = 60° to 74°, grade 3 = 75° to 89°, and grade 4 = >90°. To confirm the diagnosis of OSD, the participant had to fulfill the following clinical criteria: pain with direct pressure on the tibial apophysis; pain before, during, and after physical activities; enlargement or prominence of the tibial apophysis; pain with resisted knee extension; and pain caused by jumping.23 The following ultrasonographic findings were also required: fragmentation of the bone and irregularity of the ossification center in US (Figure 2).3,9,11,22,24,29 The physical findings were compared with the respective stages of tibial tuberosity development. Institutional review board approval for the study was provided by our institution.


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)

A longitudinal ultrasound image of the tibial tuberosity. The image shows fragmentation of the bone (arrow).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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

fig2-2325967114542084: A longitudinal ultrasound image of the tibial tuberosity. The image shows fragmentation of the bone (arrow).
Mentions: We investigated whether the subjects had pain in the tibial tuberosity on application of pressure. The height was measured with a portable height scale using graduations of 0.1 cm. Weight was measured on an electronic scale. The heel-buttock distance (HBD, cm) was measured in the prone position, and the straight-leg raise angle (SLRA) was evaluated with the participant assuming the supine position and flexing the hip with the knee extended. The straight-leg raise angles were divided into 4 groups at 15° intervals: grade 1 = <60°, grade 2 = 60° to 74°, grade 3 = 75° to 89°, and grade 4 = >90°. To confirm the diagnosis of OSD, the participant had to fulfill the following clinical criteria: pain with direct pressure on the tibial apophysis; pain before, during, and after physical activities; enlargement or prominence of the tibial apophysis; pain with resisted knee extension; and pain caused by jumping.23 The following ultrasonographic findings were also required: fragmentation of the bone and irregularity of the ossification center in US (Figure 2).3,9,11,22,24,29 The physical findings were compared with the respective stages of tibial tuberosity development. Institutional review board approval for the study was provided by our institution.

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