813 - Osgood Schlatter’s Disease Atypically Diagnosed in Adulthood

Case Diagnosis: Amongst adolescents, Osgood-Schlatter disease (OSD) is common in participants of sports and extracurricular activities. Repeated use of quadriceps muscles places stress on the tibial tubercle and causes knee pain1, which is self-resolving in adolescents.



We present a case study where OSD was atypically diagnosed in an adult with acute on chronic knee pain.

Case Description: A 50-year-old male presented for follow-up of acute on chronic bilateral anterior knee pain. Previous x-rays showed evidence of OSD, which was unlikely given his age and clinical presentation. Sports medicine believed his symptoms were related to lumbar radiculopathy. Electromyography only revealed equivocal chronic multilevel lumbar motor radiculopathy. Lumbar spine MRI did not show pathology irritating the nerve root to the knees.

The patient’s anterior knee pain remained unchanged from his last visit. Bilateral knee MRIs revealed mild proximal patellar tendon thickening correlated to overuse of the knee joint and sequelae of chronic OSD.

Discussions: It is rare to find OSD in adults because it is more common in young athletes1. Knee pain associated with OSD resolves upon epiphysiodesis1. This patient’s epiphyseal plates should have fused and not caused OSD-related pain 1. The utilization of MRI provided further sensitivity to diagnose2. This revealed thickening of the patella tendon and stress to the tibial tuberosity. Repetitive motions of the patient’s knee joint likely led to progression of his OSD3.

Conclusions: OSD should not be quickly dismissed in adults. Reports are emerging of untreated OSD in childhood, leading to chronic knee pain in adulthood. In this case, untreated tibial tuberosity fracture obscured the diagnosis of OSD4. In a report examining patients over 16 years old, OSD presented a wide range of tibial tuberosity shapes, number of ossicles, and location of the patella tendon affected5. Therefore, it is essential to consider OSD for knee pain in adults as a differential.