Lower limb pain

Question

My daughter, is13 and has CF. She has a frequent pain that can be intense in the lower limbs. Patella syndrome was diagnosed. Physical therapy was prescribed. No improvement, she consulted a rheumatologist who confirmed the patella syndrome and diagnosed Osgood Schlatter's disease. She is soon to make a bone densitometry. Osgood Schlatter usually affects boys and / or athletes. My daughter does not play sports. I wonder if other patients with cystic fibrosis have the same symptoms, and if there may be a link.

Best regards
C.

Answer

Hello,
The Osgood-Schlatter disease, also called anterior tibial osteochondrosis, is a common cause of knee pain in teenagers. Its evolution at medium and long term is usually favorable. Pain source of lameness occurs most often after exercise or sport. It can escalate and persist even at rest. Pain is related to a suffering lower insertion of the patellar tendon at the tibial tuberosity, located in the anterior knee. At palpation, the anterior tibial tuberosity appears swollen, sensitive or even painful. The knee itself, and the patella, are painless. This osteochondrosis affects mainly sporting boy between 10 and 13 years but may also occur in children or adolescents, girls or boys, who are not sporting. If its precise etiology remains unknown, many factors, genetic, traumatic, vascular, hormonal and mechanical may play a role. Treatment is based primarily on the complete cessation of physical activity and the gradual resumption of activity under supervision of the pain. Surgical treatment is considered only when complications occur or the pain persist into adulthood. The literature search found no published reports of any association with CF disease and Osgood-Schlatter. Given the high incidence of Osgood-Schlatter disease, its occurrence in a teenager suffering from cystic fibrosis as your daughter is probably coincidental.
I can only advise you to consult your physician care center who appreciate the need to review and follow-up orthopedic.
With my best regards
Gilles RAULT, MD

03.05.2011