A case study of bilateral tibial tubercle apophysitis

Abstract

Background:

Tibial tubercle apophysitis, also known as Osgood-Shlatter disease, is a chronic fatigue injury due to repeated microtrauma at the patellar tendon insertion onto the tibial tuberosity. This condition was named after an American surgeon (Robert Osgood) and a Swiss professor of surgery (Carl Shlatter).

It occurs early in childhood as the growth plates of the bones have not fused. It rarely persists throughout adulthood and is, in most cases, a unilateral condition. In most children, the condition goes undiagnosed, as few parents and caretakers bother to take their young ones to health centers for diagnosis and treatment.

This condition is a common cause of anterior knee pain in the immature athletic population. The commonly associated sports include: basketball, volleyball, sprinting, gymnastics, and football. The condition is suspected in cases of insidious atraumatic pain.

Case presentation:

A 12-year-old male presented with bilateral leg pain and swelling localized around both knee joints. The symptoms were gradual in onset and were accompanied by a mild decrease in mobility. There was no history of trauma, fever, or systemic symptoms. The patient’s medical history was unremarkable, with no previous orthopedic or systemic illnesses.

A bilateral leg x-ray revealed fragmentation of the tibial tubercles bilaterally. The overlying soft tissues were swollen and elevated.

Conclusion:

This case underscores the importance of considering bilateral tibial apophysitis in children presenting with knee pain and swelling, especially when symptoms are present in both limbs.