What Is Osgood-Schlatter Disease, and When Will It Settle?
Osgood-Schlatter disease is a common cause of knee pain in growing children. The tendon below the kneecap pulls again and again on the growth plate at the top of the shinbone. This causes pain, swelling and sometimes a bony lump you can see. It usually settles once your child's growth spurt is over, but this can take months or even a couple of years.
Key points
- Osgood-Schlatter disease is a condition linked to growth. It is not a serious injury.
- It is most common during growth spurts, usually between the ages of 10 and 15.
- The pain is felt just below the kneecap. It gets worse with running, jumping or kneeling.
- It almost always goes away on its own once the growth plate closes, when the skeleton is fully mature.
- Standing imaging can show how the alignment of the whole leg affects the knee.
What exactly is Osgood-Schlatter disease?
Osgood-Schlatter disease (sometimes called tibial tuberosity apophysitis) is an overuse condition. It affects the bony bump just below the kneecap. In children and teenagers, this area has a growth plate, a zone of developing cartilage that will later harden into solid bone. The strong thigh muscles (the quadriceps) pull on the tendon attached to this growth plate. This repeated pulling can irritate it, causing pain, swelling and sometimes a lump you can notice.
It is not a disease in the way most people understand the word. There is no infection and no permanent damage to the joint. It is a mechanical problem. It is driven by how fast a child is growing compared with how much sport or physical activity they do.
What does Osgood-Schlatter feel like?
The main sign is pain just below the kneecap. It gets worse with activity and eases with rest. Your child may describe it in different ways, but the pattern is usually the same.
An aching or sharp pain at the bony bump on the upper shin, especially during or after sport.
The area may look puffy. A firm bony bump may form that you can feel through the skin.
Running, jumping, kneeling and climbing stairs tend to bring on the pain. Rest helps it fade.
It often affects one knee, but it can affect both knees at the same time.
If your child also has numbness, weakness, a locked knee, or sudden severe swelling, get urgent medical help from your doctor or the nearest emergency department. These symptoms may point to something other than Osgood-Schlatter disease.
What causes Osgood-Schlatter disease?
The cause is fast bone growth combined with repeated mechanical stress on the growth plate. Several things make it more likely.
Bones grow faster than muscles and tendons. This increases tension on the growth plate.
Football, basketball, gymnastics and other high-impact activities increase the load on the tendon.
Tight thigh muscles pull harder on the patellar tendon and where it attaches below the knee.
Knock knees, flat feet or rotational differences can shift extra stress onto the tibial tuberosity.
It helps to know that the tendon joining the kneecap to the shinbone is the same one involved in patellar tendonitis. This is a related condition that is more common in older teenagers and adults. In younger children, the growth plate is the weakest link in the chain, so the growth plate takes the strain.
How long does Osgood-Schlatter disease last?
In most children, it lasts between 6 and 24 months. It tends to settle once the growth plate closes. This usually happens as your child reaches skeletal maturity, typically between the ages of 14 and 18, depending on how quickly they develop. In some children, symptoms come and go in waves. They flare up during busy sports seasons and ease during quieter times.
A small number of young people are left with a painless bony bump below the kneecap after the condition goes away. This is only cosmetic and does not usually cause any problems, though it can be tender if knocked directly.
Why does a standing scan help with Osgood-Schlatter diagnosis?
A standing, weight-bearing scan shows the knee, leg and pelvis exactly as they work when your child is on their feet. Standard lying-down imaging relaxes the muscles. It can hide alignment problems that only appear under load. The body is a connected chain from feet to head. So a slight rotational difference in the hip or a flat arch in the foot can shift extra force onto one knee, making Osgood-Schlatter worse on that side.
Your child stands naturally while the EOS scanner captures the full leg, from hip to ankle, in a single image. Weight is on the joints, so the image shows real-world alignment. This includes any knock-knee, rotation or pelvic tilt that changes how the knee is loaded.
The scan uses about 90% less radiation than a standard X-ray, around ten times less. Learn more about EOS scan safety and radiation.
Standard X-rays taken lying down remove the effect of gravity. The joints look different when they are not bearing weight, and alignment problems in the leg can look normal. This is why a lying-down image can miss the mechanical reason behind the knee pain.
ScanAlign standing imaging captures the whole picture. This lets your child's clinician see exactly where the strain is coming from, not just the sore spot.
When is MRI more suitable? EOS shows bones, joints and alignment clearly. If the concern is soft tissue, cartilage or ligament damage inside the knee, MRI is usually the better tool. Your child's clinician can advise which is right.
What helps manage Osgood-Schlatter symptoms?
Most children do not need to stop sport completely. Management usually focuses on adjusting activity during flare-ups and dealing with any contributing factors. Your child's doctor, physiotherapist or sports medicine specialist will guide you on the details. Common approaches include the following.
- Changing activity. Doing less jumping and running during painful spells, then slowly building back up.
- Stretching and strengthening. Gentle stretches for the quadriceps and hamstrings, together with exercises to build strength around the hip and knee.
- Ice after activity. Putting ice on for 10 to 15 minutes after sport can help ease discomfort.
- Supportive footwear. If flat feet or poor arch support are playing a part, suitable shoes or insoles may help.
ScanAlign is a diagnostic imaging clinic. We do not provide treatment, but accurate imaging of your child's alignment gives their treating clinician a clear base for any management plan.
Before your child starts treatment, or changes the one they are on, it is worth getting a detailed diagnosis. Knowing whether the cause sits in the pelvis, the legs or the spine changes what will actually help.
Wondering whether your child's knee pain is linked to how their legs are aligned? A short video call can help you decide if a trip to London for imaging is the right next step.
Book a free video consultationWhat is an EOS appointment like for a child?
Children can feel anxious about medical scans. The EOS system is open, with no tunnel or closed space, and the scan itself takes only seconds. Your child stands still in comfortable clothes while the scanner moves around them. You can stay in the room the whole time. Read more about what makes the appointment easier for children.
To learn more about how we work with younger patients, see our paediatric imaging at ScanAlign page.
Frequently asked questions about Osgood-Schlatter disease
No. It is a growth-related condition that settles on its own. It can be painful and frustrating, but it does not damage the joint and almost always goes away once the growth plate closes.
In most cases, yes, with some changes during flare-ups. Their doctor or physiotherapist can help decide when to ease off and when it is safe to carry on.
Surgery is very rarely needed. In a small number of cases, a bony fragment causes ongoing pain after growth has finished. A surgeon may then consider removing it, but this is uncommon.
It usually appears during a growth spurt, most often between the ages of 10 and 15. It can start slightly earlier in girls because they tend to reach puberty sooner.
No referral is needed. ScanAlign is a private self-pay clinic, and you can book a paediatric assessment directly.
The EOS system uses about 90% less radiation than a standard X-ray, around ten times less. This makes it especially suitable for children who may need imaging more than once while they are growing.
The pain goes away, but some children are left with a painless bony bump. It is harmless and does not affect how the knee works.
Once the growth plate has fully closed, the condition does not come back. Before that point, though, symptoms can flare up and settle several times, especially during busy sports periods.
For patients travelling from abroad, the price is confirmed during the free video consultation. You can also read our paediatric imaging page.
Standing imaging captures the leg while it is really bearing weight. Alignment problems, such as knock knees or rotational differences, only show up properly when the child is upright. This can show why one knee is taking more stress than the other.
Worried about your child's knee pain?
A free video consultation lets you talk through your child's symptoms with our team from home. You can find out whether standing imaging in London could help their clinician understand the cause.
Book a free video consultationSources
- NHS. "Osgood-Schlatter disease." nhs.uk. Accessed 2024.
- Gholve PA, Scher DM, Khakharia S, Widmann RF, Green DW. "Osgood Schlatter syndrome." Current Opinion in Pediatrics, 2007;19(1):44-50.
- Illés T, Somoskeöy S. "The EOS imaging system and its uses in daily orthopaedic practice." International Orthopaedics, 2012;36(7):1405-1411.
Author: Abbas Dhami (Specialist Diagnostic Radiographer)
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.