Which one of the following statements is correct in regard to the etiology and associated signs and symptoms in this patient?
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A 13-year-old girl presents with a history of increasingly severe left knee pain, which is limiting her ability to complete her floor exercises during gymnastic practice.Â She also complains that she is beginning to develop a similar pain in her right knee.Â On exam, she has localized tenderness and swelling over the tibial tubercle.
A. This condition develops as a result of direct trauma to the area surrounding the tibial tubercle B. Tenderness when applying pressure over the patella is common associated finding on physical exam C. Steroid injection is the treatment of choice because it offers prompt relief of pain and allows for return to sports participation D. X-rays of the involved extremity typically show â€śbeakingâ€ť of the tibia associated with collapse of the medial epiphysis E. This condition is most common during or recently after a rapid growth spurt
This condition is most common during or recently after a rapid growth spurt-this patient has osgood-schlatter disease, which results from an avulsion of a portion of the ossification center causing a traction apophysitis of the tibial tubercle. it occurs during periods of rapid growth during adolescence and is slightly more common in males. it is most common in young athletes involved in jumping sports, such as basketball and gymnastics, and is not the result of a direct-impact injury. repetitive contraction of the quadriceps muscle places stress on the tibial tuberosity.
patient present with localized tender swelling overlying the tibial tubercle, which is worsened by activity and relieved by rest and non-steroidal anti-inflammatory agents (nsaids). in some patients, a palpable bony mass is associated with the overlying swelling. range of motion of the knee is normal. symptoms are well localized to the tibial tubercle and the patellar tendon region. examination of the patella is normal in patient siwth osgood-schlatter disease. radiographs are not routinely recommended if the diagnosis is straightforward based on the clinical exam. radiographic signs may include soft tissue swelling anterior to the tibial tubercle, irregularity, and fragmentation of the tubercle or a superficial ossicle in the patellar tendon. steroid injection is contraindicated because damage to the patellar tendon may result. most patients respond to symptomatic treatment with physical therapy to strengthen the quadriceps muscles, and non-steroidal anti-inflammatory treatment. patients may continue to participate in sports. symptoms can be expected to resolve within 1-2 years.
board testing point: know signs, symptoms, and etiology of osgood-schlatter disease.