Definition
Condition of traction apophysis into which part of patellar tendon inserts
- pulling osteochondritis of tibial tubercle
Epidemiology
Early teens
- M:F
- corresponds with growth spurt
- M 12-14
- F 11-13
- 1/3 bilateral
- athletes 21% vs 5% normal
Aetiology
Traction injury
- due to recurrent tensile microtrauma to an immature patella insertion
- usually no history of injury
Symptoms
Activity related pain
- especially kicking & jumping
- pain on direct blow
- difficulty kneeling
Signs
Tender lump over tibial tuberosity
Pain on active extension
X-ray
Exclude other causes
- enlarged fragmented tibial tuberosity
CT scan
May define ossicle in patellar tendon
- 10%
Management
Usually resolves spontaneously
- NSAID oral and topical
- hamstring stretching
- restriction of provocating activities
Steroid injections contra-indicated
Removal of ossicle if remains painful and mobile
