Initial pre-referral workup

Clinical history

Most frequent cause of knee pain in children aged 10 to 15 years.

Physical examination

• pain and swelling over the tibial tubercle
• prominent and tender tibial tubercle 

Investigations

Plain radiographs are used to rule out serious pathology such as:

• neoplasm
• acute tibial apophyseal
• fracture
• infection

GP management

Reassurance parents that this is a self-limiting condition and symptoms will resolve with skeletal maturity (i.e. when the bones finish growing).

Modify activities to manage the pain. Jumping or kicking activities should be avoided.

Local measures such as ice, anti-inflammatories and quadriceps stretching are recommended.

Refer parents to Osgood-Schlatters in children (fact sheet) and quadriceps stretching program.

Indications for specialist referral

Routine

• symptoms not resolving with conservative treatment
• home stretching program
• symptoms persisting  longer than 18 months