Osgood- schlatter syndrome
description
Transcript of Osgood- schlatter syndrome
OSGOOD-SCHLATTER SYNDROMERIS Accession: 114043
1 yo FS Mastiff with progressive difficulty rising and ambulating
Osgood-Schlatter syndrome in humans
Definition and Etiopathogenesis Traction apophysitis of the tibial tubercle Due to repetitive strain (tension of the quadriceps
mm.) and chronic avulsion of the tibial tuberosity Avulsion typically prior to complete ossification of
tubercle, which continues after avulsion Tissue between the avulsed tuberosity and tibia
may become fibrous, with a localized nonunion Alternatively may eventually reunite with tibia with
persistent enlargement of the tibial tuberosity
Osgood-Schlatter syndrome Clinical features
Syndrome recognized in children 8-15 yo Local pain, swelling,
tenderness over tibial tuberosity
Symptoms exacerbated by jumping or kneeling
Bilateral 20-30%
Variable and contradictory reports of predisposing conformation No universally accepted conformational risk factors Gholve, 2007
Osgood-Schlatter syndromeRadiographic features
Peracute Soft tissue swelling
(avulsion of cartilage) Early
Irregularity of the apophysis
Separation from the tibial tuberosity
Later Fragmentation of the
tibial tuberosity Persistent ossicle
beyond the fusion of tibial epiphysis
Blunting of the infrapatellar fat pad
Thickening, poor demarcation of the tendon
Gholve, 2007
Osgood-Schlatter syndromeMRI findings
Normal Partial cartilaginous
avulsion of secondary ossification center-mixture of high and low signal on T2W
Separate ossicles
Edema and thickening of the patellar tendon near its insertion
Edema of Hoffa’s fat pad inferiorly
Dwek, 2008
Osgood-Schlatter syndrome
Fractures Are tibial
tuberosity avulsion fractures a part of Osgood-Schlatter syndrome? Variable classification
Fractures may ramify along the proximal tibial physis
“Proximal tibial Salter fractures are frequently preceded by Osgood-Schlatter-type abnormalities.” Dwek, 2008
Osgood-Schlatter syndrome
Treatment90% respond to conservative management, however, may be clinical for 12-24 months
Rare cases require surgery to remove ossicles and cartilaginous material if clinical signs continue into adulthood
Osgood-Schlatter syndrome in dogs? Maybe not…
Tibial tuberosity avulsion fractures in dogs: review of 59 dogs 65 tibial tuberosity avulsion fractures in
59 dogs 89% were Staffordshire Bull terriers Age at presentation 3-10 months 58% had an incident that resulted in
peracute lameness; typically non-weight bearing lame, spontaneous improvement within 24-48 hrs
Tibial tuberosity avulsion in dogs
Fracture patterns 57% 23% 20%
Tibial tuberosity avulsion fractures
Proposed predilectionsOsteochondrosisGenetic linkSimilar to syndrome in teenagers without underlying physeal abnormality
References Gholve, et al. Osgood Schlatter
syndrome. Curr Opin Pediatr 2007; 19:44–50.
Dwek JR, Chung CB. The patellar extensor apparatus of the knee. Pediatr Radiol 2008; 38:925-935.
Gower JA, Bound NJ, Moores AP. Tibial tuberosity avulsion fracture in dogs: a review of 59 dogs. Journal of Small Animal Practice 2008; 49, 340–343.