Correlation between Magnetic Resonance Imaging Characteristics of the Patellar Tendon and Clinical Scores in Osgood-Schlatter Disease

Lee, Dhong Won; Kim, Min Jeong; Kim, Woo Jong; Ha, Jeong Ku; Kim, Jin Goo

doi:10.5792/ksrr.2016.28.1.62

Cited by 11 publications

(24 citation statements)

References 22 publications

(40 reference statements)

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“…Of the studies that reported sex and age range, 70% were male, and 30% were female, with adolescents aged from 9 to 17 years. Five studies included adults with unresolved OSD aged 18‐39 years 11‐15 . Full study characteristics are summarized in Supplemental Material, Table S1.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of imaging findings in patients with Osgood‐Schlatter disease

Sørensen

Rathleff

Dean

et al. 2021

Translational Sports Med

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This systematic review aimed to describe the imaging characteristics of Osgood‐Schlatter (OSD) compared with controls and imaging findings over time. A systematic search was conducted in Embase, CINAHL, and PubMed from inception until July 2021. Forty studies were eligible and included based on inclusion criteria on OSD diagnosis, the number of patients, and imaging outcomes. In patients with OSD, but not controls, findings were soft‐tissue swelling of the cartilage and infrapatellar bursa, tendon changes, increased Doppler flow, and fragmentation of the secondary ossification center. Follow‐up studies reported improvements over time, but some identified persistent tendon thickening and/or ossicles. Adults with OSD generally present with free ossicles. Findings were inconsistent on whether different morphometric features were altered in OSD compared to controls. OSD patients were classified within the early stages of tibial tuberosity maturation. This review documents that OSD presents with tissue alterations that do not appear in controls or the patient's asymptomatic knee. Notably, a large portion had tendon involvement, and ossicles seem to be associated with residual symptoms after maturation. Standard imaging of adolescents with OSD needs to be carefully considered when determining if tissue alterations are related to disease progression or part of the normal maturation.

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Section: Resultsmentioning

confidence: 99%

A systematic review of imaging findings in patients with Osgood‐Schlatter disease

Sørensen

Rathleff

Dean

et al. 2021

Translational Sports Med

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“… 5 It is considered an apophyseal injury of the tibial tuberosity, the site of attachment of the patellar tendon onto the tibia. 1 , 11 , 15 The weak apophyseal cartilage is thought to be susceptible to injury before the apophysis is fully matured. 18 , 31 Although the etiology is not fully understood, characteristics such as cartilage swelling and associated tendon changes (including thickening of the patellar tendon and increased Doppler activity) have been documented in patients with OSD.…”

mentioning

confidence: 99%

“…On the contrary, there are documented cases of adults with residual symptoms/sequalae resulting from OSD. 3 , 15 , 21 , 28 A retrospective study from Krause and colleagues 13 in 1990 stated that at long-term follow-up (mean, 9 years), as many as 1 in 4 patients had continuing additional symptoms into adulthood. The extent of the severity and impact on sport, physical activity, and life in this group was not documented.…”

mentioning

confidence: 99%

Is the Prognosis of Osgood-Schlatter Poorer Than Anticipated? A Prospective Cohort Study With 24-Month Follow-up

Holden

Olesen

Winiarski

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Osgood-Schlatter disease (OSD), an apophyseal injury of the tibial tuberosity, affects up to 1 in 10 adolescents. This condition has previously been assumed to be innocuous and to self-resolve with limited intervention. Purpose: To investigate the 24-month prognosis of OSD and examine if ultrasound (US) classification is associated with outcomes. Study Design: Case series; Level of evidence, 4. Methods: This study included a preregistered prospective cohort of 51 adolescents (aged 10-14 years) diagnosed with OSD who were evaluated for 24 months. The primary outcome at 24-month follow-up was whether participants continued to experience OSD-related knee pain. Baseline US scans were collected and characterized by OSD type (De Flaviis classification) as well as maturation of the tibial tuberosity. Secondary outcomes included sports participation, Knee injury and Osteoarthritis Outcome Score (KOOS) Sport/Recreation subscale, and health-related quality of life (European Quality of Life–5 Dimensions–Youth [EQ-5D-Y]). All participants were invited for re-examination by US at follow-up. Results: A total of 51 patients preregistered for the study, with 90% (n = 46) available at follow-up. Of these 46 participants, 37% (n = 17) still reported knee pain due to OSD. In this subgroup, the median duration since symptom onset was 42 months (interquartile range, 38-51 months). More than 1 in 5 participants reported stopping sport due to knee pain, and those who continued to experience knee pain reported significantly worse KOOS Sport/Recreation scores at follow-up compared with patients with no knee pain (mean 74 [95% CI, 63-84] vs 91 [95% CI, 85-97]). Participants with continued OSD-related pain also had lower health-related quality of life (mean difference in EQ-5D-Y, 0.11 [95% CI, 0.06-0.13]). Higher De Flaviis classification at baseline was significantly associated with an increased risk of knee pain at 2 years. Diagnostic US at follow-up demonstrated primarily tendon changes (thickening, positive Doppler signal), as well as an ununited ossicle in 32% of participants who underwent US scanning at follow-up. Conclusion: Over one-third of the study participants had knee pain at 2-year follow-up, which was associated with lower sports related function and health related quality of life. This questions the assumption that all patients with OSD experience quick recovery. Participants without any changes on imaging at baseline were less likely to report pain at follow-up.

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“…[1][2][3] The etiology of the disease has not yet been fully clarified; however, several authors tried to explain the underlying pathologies, as they have identified some potential risk factors and proposed various theories about the etiology. [3][4][5][6][7][8][9][10] Although some authors have shown an association between OSD and shortness of the rectus femoris muscle, others have claimed that limited foot dorsiflexion played a role in the etiology of the disease. 7,9 Guler et al drew attention to the positive relationship between OSD and attention deficit hyperactivity disorder (ADHD).…”

mentioning

confidence: 99%

“…1 Although it has been defined as an overuse syndrome seen in highly active children but it is not seen in every child who does the same sporting activity and performance. 4,5 Thus, there may be some subtle anatomic characteristics or variations of the knee extensor mechanism, such as patellofemoral alignment that is responsible for the emergence of OSD. 6,7 In other words, some children may be predisposed to developing OSD due to certain anatomic variations in the extensor mechanism.…”

mentioning

confidence: 99%

Is There a Relationship between Patellofemoral Alignment and Osgood–Schlatter Disease? A Case-Control Study

et al. 2018

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This study was aimed to investigate the role of anatomic variations in patellofemoral alignment in patients with or without Osgood-Schlatter disease (OSD) and to determine the potential anatomic risk factors that may play role in the etiology. This prospective observational case-control study was conducted on two groups of adolescent patients. Group 1 comprised patients who were diagnosed as having OSD and group 2 consisted of an equal number of age-matched patients who presented to the outpatient clinic with traumatic knee injury and underwent knee radiographic examination but without a diagnosis of OSD. Age, height, weight, body mass index (BMI), dominant side, and level of sporting activity were recorded. Quadriceps (Q) angles were measured using a long-arm goniometer with patients lying in the supine position with their knees in full extension and contracting the Q muscles. On anteroposterior, lateral knee, and tangential patella (Merchant and Laurin views) radiographs, the following measurements were performed: Insall–Salvati (IS), Caton–Deschamps (CD), and Blackburne–Peel (BP) indexes, congruence angles, lateral patellofemoral angles, sulcus angles, and patella type according to Grelsamer's morphology classification. Both groups were similar in respect of age (p = 0.160), sex (p = 0.311), height (p = 0.326), weight (p = 0.596), BMI (p = 0.153), and dominancy (p = 0.500). The rate of patients engaged in sports activities was significantly greater in the OSD group (p = 0.003). No significant difference was determined between the groups in respect to IS index, CD index, BP index, sulcus angle, lateral patellofemoral angle, and congruence angle (p–values: 0.358, 0.995, 0.912, 0.802, 1.000, and 0.907, respectively). The mean Q angle was measured as 15.6 ± 2.2 degrees in the OSD group and 14.3 ± 2.5 degrees in the control group (p = 0.014). Despite the difference being statistically significant, it was clinically insignificant because the difference was only 1.3 degrees. The principle etiologic factor seems to be increased physical activity rather than subtle variations is patellofemoral anatomy and alignment of extensor mechanism.

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Correlation between Magnetic Resonance Imaging Characteristics of the Patellar Tendon and Clinical Scores in Osgood-Schlatter Disease

Cited by 11 publications

References 22 publications

A systematic review of imaging findings in patients with Osgood‐Schlatter disease

A systematic review of imaging findings in patients with Osgood‐Schlatter disease

Is the Prognosis of Osgood-Schlatter Poorer Than Anticipated? A Prospective Cohort Study With 24-Month Follow-up

Is There a Relationship between Patellofemoral Alignment and Osgood–Schlatter Disease? A Case-Control Study

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