Abstract
BackgroundOsgood–Schlatter disease (OSD) is a non-traumatic knee problem that is primarily observed in sports-active children and adolescents aged 8–15 years.AimTo determine the incidence of OSD and to gain an insight into the management of children and adolescents with OSD in general practice.Design and settingA retrospective cohort study was conducted using a healthcare database containing full electronic health records of over 200 000 patients in general practice in and around the Dutch city of Rotterdam.MethodPatients with a new diagnosis of OSD from 1 January 2012 to 31 December 2017 were extracted using a search algorithm based on International Classification of Primary Health Care coding and search terms in free text. Data on the management of OSD were manually interpreted.ResultsThe mean incidence over the study period was 3.8 (95% confidence interval [CI] = 3.5 to 4.2) per 1000 person–years in those aged 8–18 years. Boys had a higher incidence rate of 4.9 (95% CI = 4.3 to 5.5) compared with girls (2.7, 95% CI = 2.3 to 3.2). Peak incidence was at 12 years of age for boys and 11 years for girls. Advice was the most commonly applied strategy (55.1%), followed by rest (21.0%), referral for imaging (19.5%), and physiotherapy (13.4%).ConclusionTo the authors’ knowledge, for the first time the incidence of OSD has been calculated using GP electronic medical files. There is a discrepancy, especially for imaging and referral to a medical specialist, between the current Dutch general practice guidelines and how GPs actually manage the condition in clinical practice.
Highlights
Knee pain (32%) is the most frequently reported musculoskeletal pain complaints during adolescence[1]
This study is the first retrospective cohort study that provides insight in the incidence of Osgood-Schlatter disease (OSD) in general practice as well as the different management types used by general practitioner (GP)
In this study we discovered a discrepancy between Dutch guideline for general practitioners (NHG) and the described management
Summary
Knee pain (32%) is the most frequently reported musculoskeletal pain complaints during adolescence[1]. Knee pain account for the second highest number of general practice consultations for musculoskeletal problems in children and adolescents aged between 3 and 19 years old[2]. In Dutch general practice the incidence of consultations due to knee pain range from 10.6 to 17.4 per 1000 patients between the age of 4 and 24. Most studies focused on musculoskeletal or knee problems in general, are open population surveys and often not in the age-range where OSD mostly is observed. The objective of this study was to estimate the age- and sex-specific incidence of OSD in Dutch general practice and to gain insight in the different types of management strategies applied by GPs. Schlatter disease (OSD) is a non-traumatic knee problem that primarily observed in sports active children and adolescents between the age of 8 and 15
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