Osgood-Schlatter Disease as a Possible Cause of Tibial Tuberosity Avulsion

Osgood-Schlatter disease (OSD) proposes that bony microtrauma of the patellar tendon insertion on the tibial tuberosity may be due to inappropriate stress with adolescent activity, and is a common pathology among pediatric patients. Lack of activity restrictions may further contribute to significant bony damage due to continued quadriceps contraction, which in some cases results in a tibial tuberosity avulsion fracture. Evaluation in the ED should include distal neurovascular status, as compartment syndrome has also been documented. Radiographs are generally definitive for diagnosis; however, bedside ultrasound and CT may help further define injury severity and delineate conservative rather than operative management. We highlight the case of a 13-year-old male with a recently diagnosed history of OSD who presented to the ED for severe knee pain after landing forcefully onto the ipsilateral foot and was found to have a large avulsion fracture of the tibial tuberosity. We also provide a brief review of the literature.