The tibial tuberosity is not fractured, the diagnosis and examination should be careful

Patients with tibial tubercle suffer from skeletal bacterial necrosis due to inflammation and tuberous osteochondrosis, which causes many complications. Different factors will lead to different clinical manifestations. Many people think that the symptoms are due to fractures, but they are not. Patients need to undergo appropriate treatment and examination after clearly identifying the factors of the disease.

Tibial tubercle epiphysisitis, also known as tibial tubercle osteochondrosis, tibial tubercle osteochondritis, and aseptic necrosis of tibial tubercle epiphysis. Judging from the naming of various etiologies, there is no unified understanding of its cause and pathological nature. Foreign literature often calls it Osgood-Schlatter disease, which was reported by Osgood and Schlatter at the same time in 1903.

Causes

It is generally believed that the tibial tuberosity epiphysis is the result of acute or repeated chronic injury under the traction of the patellar tendon. The epiphysis is the center of bone development during growth, and the tibial tubercle epiphysis is located on the proximal, anterior side of the tibia, at the attachment point of the quadriceps patellar tendon.

Epiphysisitis in many parts of the body almost always occurs during the development and growth period. Abnormal epiphysis development should be the basis for the onset of epiphysisitis and epiphyseal osteochondrosis.

Clinical manifestations

It is common in boys aged 11 to 15 during puberty, most of whom are those who develop rapidly and like sports, and may have a history of strenuous exercise or trauma. Pain in the tibial tuberosity, worsened by activity. The tibial tubercle may be locally swollen, tender, or even red and hot. The pain is aggravated by active knee extension, passive knee flexion or squatting, and is caused by the patellar tendon pulling the epiphysis.

examine

X-ray manifestations: Tangential position of the tibial tubercle shows swelling of the covering soft tissue, thickening of the patellar tendon, and bulging of the epiphysis. There is uneven ossification between the two, and there may be raised bone fragments or free bone fragments. The free bone fragments do not heal for a long time, but the symptoms can be completely eliminated. MRI may show patellar tendinitis or visualize the infrapatellar bursa.

Differential Diagnosis

The diagnosis is not difficult, but it is necessary to distinguish it from osteosarcoma. Osteosarcoma is a primary malignant bone tumor, and the proximal tibia is also a common site. Adolescence is also a common period.

treat

The disease is self-limiting, meaning it heals on its own without the need for medication. Patients are only advised to rest, limit knee joint activity, avoid running, jumping, and walking for long periods of time. If the attack is acute, external fixation with plaster can be used. Although local blockade with glucocorticoids can quickly relieve pain, it can cause tissue degeneration and necrosis and spontaneous rupture of the patellar tendon, and is not recommended for use.