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NSG-5003

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Case Study 2

The case concerns the case of 13-year-old male adolescent with recurring anterior knee pain, which is recurrently instigated by physical activity on both sides. His family and medical history are unimpressive; his general symptoms do not include fever, swelling, or a limitation of ambulation, etc. Physical examination reveals that tibial tubercles are tender, and pain is recreated on resistance knee extension (Alharbi et al., 2025). Such a clinical presentation is characteristic of an overuse injury in a sports-related adolescent; therefore, it is important to identify and clarify the pathogenesis and to give the patient the required treatment and educational program.

Most Likely Diagnosis

In this patient, the most probable diagnosis is the Osgood-Schlatter disease (OSD), which is a traction apophysitis of the tibial tubercle. It is common among adolescents engaged in sports activities that involve running, jumping, or taking a sharp turn, which in this case is associated with a two-year history of being part of school soccer teams. OSD is, in most cases, bilateral, common among active sportsmen, and is typified by local tenderness of the tibial tubercle, exacerbated by exercise (Corbi et al., 2022).

Pathogenesis of Osgood-Schlatter Disease

OSD is caused by the results of the repetitive strain and microtrauma of the tibial tubercle, in which the patellar tendon is inserted. Compared to the former, the tibial apophysis is quite weak and easily inflamed at the stages of active development of the adolescent period. This is due to running and jumping causing repetitive traction forces on the apophysis, which causes pain, tenderness, and swelling at times. It is a self-limiting condition that usually resolves itself with the achievement of skeletal maturity, at which point the growth plates ossify.

Additional Information for Diagnosis

OSD is a disease that is primarily diagnosed. Additional critical data include history of the pains of activity, local tenderness of the area surrounding the tibial tubercle, and pain aggravation when the knee is performing the extension movement against the resisted knees or as it is attempting to jump. Radiographs are infrequently required, and it may be implied to exclude other etiologies, e.g., fractures or avulsion injury, in case of the unusual manifestation (Rhim et al., 2025). Bilateral presentation and absence of systemic symptoms of fever or erythema are also further characterized as OSD rather than an infectious disease or inflammation.

Treatment Strategies

OSD comes as a conservative management. The relevant interventions include the adjustment of activities to reduce the high-impact movements, ice application to reduce the pain and inflammation, and the on-demand application of nonsteroidal anti-inflammatory drugs (NSAIDs). Bending and stretching of the muscles surrounding the hamstrings, quadriceps, and others are used to reduce the traction on the tibial tubercle. In some uncommon and chronic cases, knee padding or orthotics can be used (Zeng et al., 2025). Surgery is not very common, and it is only administered in severe cases of the symptoms and in cases of refractoriness after skeletal maturity.

Patient and Parent Education

There should be education of the patient and the mother. They should be taught that OSD is a restrictive disorder that tends to clear with the skeletal frame maturing. The increased symptoms should be prevented by emphasizing the use of activity modification and home exercise programs. It is necessary to inform the parents that, despite the need to pause some of the sports, there is no need to be completely inactive (Alharbi et al., 2025). Additionally, it is necessary to note changes, such as swelling, asymmetry, and acute trauma, which may be indicators of other traumas, and the patient has to pass further tests.

Conclusion

The scenario of an Osgood-Schlatter disease is a characteristic of an overuse injury in youngsters who are of the active stage of rapid development; that is, an adolescent male. The awareness of the pathogenesis and recognition of clinical signs, in addition to the implementation of conservative methods of treatment, will allow to effectively manage with minimum damage to physical activity. Patient and parent education is crucial in treatment adherence and safe sports participation until skeletal maturation, when the condition stops.

References

Rhim, H. C., Bjork, L. B., Shin, J., Park, J., DeLuca, S. E., McCarron, K. C., Jang, K.-M., & Ha, C. (2025). Efficacy of hyperosmolar dextrose injection for Osgood–Schlatter disease: A systematic review with meta-analysis. Diagnostics, 15(10), 1282. https://doi.org/10.3390/diagnostics15101282

Zeng, F. T. A., Dezoumbet, O. B. P., Diedhiou, Y., Wellé, I. B., Tilali, S., Gueye, D., Mbaye, P. A., Ndoye, N. A., Ndour, O., & Ngom, G. (2025). Osgood-Schlatter disease in sub-Saharan African children: a single-center review. Egyptian Pediatric Association Gazette, 73(1), 29. https://doi.org/10.1186/s43054-025-00370-x