Magnetic resonance imaging of Osgood-Schlatter disease: the course of the disease

Abstract

We clarified the progress of OSD with MRI. The process of OSD started from the apophyseal stage and a tear appeared in the secondary ossification center, widening to an opened shell-like shape. This damage progressed to an ossicle in some cases. In short, the ossicle was formed from an avulsed portion. It was very difficult to show the course of OSD with radiography. MR images were especially useful for revealing early and progressive lesions of OSD.

Precise risk factors for Osgood–Schlatter disease

“…The results concerning quadriceps femoris muscle tightness were consistent with those of earlier reports [3]. OSD is a traction apophysitis of the tibial tubercle caused by overload/microfractures in the attachment of the patellar tendon [1,8]. The repetitive strain, in turn, is caused by the strong pull produced by the quadriceps femoris muscle during sporting activities.…”

“…Ultrasonography is useful for the visualization of orthopedic conditions, especially soft tissue diseases, and it is particularly effective in the early diagnosis of OSD [16]. Early detection of OSD and conservative treatment can enable an early return to sporting activities [7,8].…”

Hyperosmolar Dextrose Injection for Recalcitrant Osgood-Schlatter Disease

“…5 Improvement in patellar tendinosis was demonstrated in those that became asymptomatic, despite persistence of nonunion ossicles. 5 Hirano et al, 6 in another sequential MRI study, found that a partial tear of the secondary ossification center was in place before patellar tendon swelling but agreed that symptom resolution likely follows the resolution of tendon changes. Thus, although repeated microavulsion fractures may be the first radiographic finding and contribute to OSD pain and pathology, 6 they do not seem to be the primary source of pain and dysfunction.…”

“…5 Hirano et al, 6 in another sequential MRI study, found that a partial tear of the secondary ossification center was in place before patellar tendon swelling but agreed that symptom resolution likely follows the resolution of tendon changes. Thus, although repeated microavulsion fractures may be the first radiographic finding and contribute to OSD pain and pathology, 6 they do not seem to be the primary source of pain and dysfunction. 5,6 Recent MRI and ultrasound reports are also consistent with a description of OSD as "a tendinopathy/ apophysosis of the patellar tendon/tibial tubercle."…”

“…Thus, although repeated microavulsion fractures may be the first radiographic finding and contribute to OSD pain and pathology, 6 they do not seem to be the primary source of pain and dysfunction. 5,6 Recent MRI and ultrasound reports are also consistent with a description of OSD as "a tendinopathy/ apophysosis of the patellar tendon/tibial tubercle." [7][8][9][10][11][12] Safety and level A-C evidence of efficacy (per US Preventive Services Task Force criteria) of injection of 10% to 25% dextrose in areas of damaged ligament, tendon, and cartilage in adults has been demonstrated in randomized controlled trials in Achilles tendinosis, 13 finger osteoarthritis, 14 knee osteoarthritis, 15 lateral epicondylosis, 16 sacroiliac joint pain, 17 and in case series collections of patients with Achilles degeneration, 18,19 anterior cruciate ligament laxity, 20 coccygodynia, 21 hip adductor and abdominal tendinosis, 22 and plantar fasciosis.…”