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RIS Accession: 114043

Osgood- schlatter syndrome

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Osgood- schlatter syndrome. RIS 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 - PowerPoint PPT Presentation

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Page 1: Osgood- schlatter  syndrome

RIS Accession: 114043

Page 2: Osgood- schlatter  syndrome
Page 3: Osgood- schlatter  syndrome

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

Page 4: Osgood- schlatter  syndrome

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

Page 5: Osgood- schlatter  syndrome

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

Page 6: Osgood- schlatter  syndrome

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

Page 7: 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

Page 8: 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

Page 9: Osgood- schlatter  syndrome

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

Page 10: Osgood- schlatter  syndrome

Fracture patterns 57% 23% 20%

Page 11: Osgood- schlatter  syndrome

Proposed predilectionsOsteochondrosisGenetic linkSimilar to syndrome in teenagers without underlying physeal abnormality

Page 12: Osgood- schlatter  syndrome

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.