An overuse syndrome of paediatric population that typically affects young athletes during their adolescent growth spurt.

Pathophysiology:

Stress from running, jumping and other movements at the same time as growth in the epiphyseal plate result in inflammation on the tibial epiphyseal plate. There are multiple small avulsion fractures, where the patella ligament pulls away tiny pieces of the bone.

This leads to growth of the tibial tuberosity, causing a visible lump below the knee. Initially this bump is tender due to the inflammation, but has the bone heals and the inflammation settles it becomes hard and non-tender.

Risk factors:

• Adolescent males (aged 10-15 years)
• Athletic participation
• History of OSD in the contralateral knee

PC

*presence of R/F

• Pain at the tibial tuberosity - Exacerbated by forceful extension, relieved by rest, ice, anti- inflammatory meds
• Inability to maintain physical activity

On examination:

• Localised tenderness on palpation
• Localised swelling and warmth at tibial tuberosity
• Prominant tibial tubercle
• Pain at tubercle with resisted knee extension