(Tibia) disease

(Tibia) disease [synonym. Osgood (Tibia) disease (R. Osgood, S. Schlatter)] - osteochondropathy tuberosity of the tibia. In appearance play a role as direct trauma and re mikrotravmatizatsiya area tuberosity of the tibia and reinforced and frequent over-voltage own the patellar tendon at reductions of the quadriceps muscle of thigh.
(Tibia) the disease is accompanied by a small margin: nucleoli of ossification of the tibial tuberosity (Fig. 1) or particles, breaks is part of the fibrils own the patellar tendon in places of attachment to Apophis, local small hemorrhages, aseptic posttraumatic inflammation, sometimes recurrent, in the area of mucous bags and first of all the subcutaneous odnaclassniki (bursa subcutanea infrapatellaris) and odnaclassniki deep (bursa profunda infrapatellaris). (Tibia) the disease occurs as a rule, only in the period of growth, often in boys 12-14 years, especially in athletes. In the area of the tibial tuberosity gradually appears sickly pale when pressure protoliticheskie swelling, through which probed hard ledge. Often failure is bilateral. Local pain can occur spontaneously, but more often they are called in random local pressure or injury and movements associated with the extension of the knee joint.

disease (Tibia)
Fig. 1. Disease (Tibia). Traumatic offset part of the nuclei of ossification of the tuberosity of the tibia bones, more pronounced on the left.
schlatter disease
Fig. 2. Exostosis and bone fragment after a long illness (Tibia).

The disease (Tibia) chronic, sometimes wavy, with occasional outbreaks. Disease usually lasts no longer than 10-20 years. and usually ends with a recovery before the merge kernel ossification tuberosity with the subject metafizik, i.e. up to 17-19 years. However, painless swelling of the tibial tuberosity remains forever. Disease (Tibia) does not cause fever, no changes in the peripheral blood, no complications. The diagnosis is based on a characteristic clinical signs, localization process, chronic; the importance of gender and age of the patient. These same characteristics also used for differential diagnosis of the disease (Tibia) with a broken bone, osteomyelitis, tuberculosis, syphilis and neoplasms. But the crucial method of diagnosis is x-ray examination, especially convincing in the dynamics of observation.
At the beginning of the disease on the side radiograph proximal tibia is the normal state of the kernel (or cores) of ossification of the tibial tuberosity, continuous or intermittent proboscis descending from the epiphysis (this picture can be asymmetric both limbs); visible only thickening soft cover tuberosity and improving the bottom border of a quadrangular enlightenment (due to the fatty tissue in front of the joints) as a result of inflammatory increase the deep odnaclassniki bags. In the dynamics of observation reveals the bias 1-3 shadows small bone cells, often irregular, from a group of nuclei of ossification tuberosity anterior upward, usually up to 2-5 mm; often all the core ossification bit is shifted forward by 1 to 3 mm due to reactive thickening subject cartilage. The shape of the nuclei of ossification and subject area of the metaphysis tibia can become uneven, and trabecular structure can be fuzzy. With time shifted bone cells may disappear; rather they merge with other parts of the kernel of Apophis in a single bone conglomerate, a broad base coming from the tuberosity of the tibia and rough, rough, sometimes thorn ledge directed upwards and a little to the front, where he continues to own a bunch of patella (Fig. 2). Sometimes in the distal part of the latter, near tuberosity, noticeable isolated focus old ossification ligaments rounded or irregular shape with a diameter of not more than 4-6 mm
A serious error is the classification of diseases (Tibia) the pain in the tuberosity of the tibia in an adult, after its confluence with metafizik, usually caused aseptic inflammation of mucous bags.
Treatment disease (Tibia): unloading and peace limbs, warm compress on the night, casing blockade.
Cm. also Osteochondropathy.