Growth spurt may be behind adolescent's sore knees

My "real" patient that morning was the young lady who was in for her third and final cervical cancer vaccine. Since it was a school holiday, her 13-year-old brother was along for the ride and mom thought to ask a question about her son as long as he was around.

The athletic teen was going through a rapid growth spurt and complaining of frequent episodes of bothersome knee pain, especially after activity. Mom had already done an Internet search using reputable medical Web sources and had a good grasp of her son's probable diagnosis. I looked at the boy's gangly legs and knobby knees and told mom that I agreed with her conclusion: Osgood-Schlatter disease.

Osgood-Schlatter's is not really a disease in the usual sense of the word - more accurately describing a common "overuse" orthopedic condition that develops in some kids during their tween or early teen years.

The knee itself is not the issue as much as the area right under the knee cap. Here, inflammation can result from heavy physical activity as the quadriceps muscles in the thigh repeatedly pull on the patellar tendon, which in turn pulls at the tibia.

Children with Osgood-Schlatter disease experience pain and swelling of the tibial tuberosity, or the top portion of the tibia located just beneath the knee cap. Both lower limbs can be involved, though it's not unusual for one side to be affected without, or more severely, than the other. That leads to one tibial tuberosity that appears more prominent and that aches more than its partner.

Orthopedic experts at the Mayo Clinic note that Osgood-Schlatter's is seen most often in young athletes, affecting up to 20 percent of these active teens. Those particularly at risk include participants in running and jumping sports and sports that require executing rapid changes in direction - think soccer players and figure skaters, among others.

The peak age of Osgood-Schlatter's correlates well with puberty, so it's no surprise that the condition is typically seen in girls around ages 11 to 12 and in boys at ages 13 to 14.

The tibial swelling and discomfort, which are the hallmarks of Osgood-Schlatter's, are aggravated by physical activity and improve to some degree with rest. The good news for affected athletes is that this orthopedic condition is not permanent and usually fades away as the growth rate finally slows.

Osgood-Schlatter disease can be managed by encouraging the young athlete to warm up and stretch properly before activity, and to ice and rest the affected area after each practice and sporting event. Over-the-counter anti-inflammatory medications can also help children and adolescents deal with the inevitable discomfort.

Though Osgood-Schlatter's can be a fairly straightforward diagnosis, if the child's exam or history doesn't fit the typical pattern of the disease, or if the young athlete remains unable to participate in regular daily activities or sports because of the pain and swelling, consider a consultation with an orthopedic specialist for further recommendations and treatment.