Search

OBJECTIVES: Osgood-Schlatter disease is an overuse musculoskeletal pain condition. The pain mechanism is considered nociceptive, but no studies have investigated nociplastic manifestations. This study investigated pain sensitivity and inhibition evaluated through exercise-induced hypoalgesia in adolescents with and without Osgood-Schlatter.DESIGN: Cross-sectional study.METHODS: Adolescents underwent a baseline assessment comprising clinical history, demographics, sports participation, and pain severity rated (0-10) during a 45-second anterior knee pain provocation test, consisting of an isometric single leg squat. Pressure pain thresholds were assessed bilaterally at the quadriceps, tibialis anterior muscle, and the patella tendon before and after a three-minute wall squat.RESULTS: Forty-nine adolescents (27 Osgood-Schlatter, 22 controls) were included. There were no differences in the exercise-induced hypoalgesia effect between Osgood-Schlatter and controls. Overall, an exercise-induced hypoalgesia effect was detected at the tendon only in both groups with a 48 kPa (95 % confidence interval 14 to 82) increase in pressure pain thresholds from before to after exercise. Controls had higher pressure pain thresholds at the patellar tendon (mean difference 184 kPa 95 % confidence interval 55 to 313), tibialis anterior (mean difference 139 kPa 95 % confidence interval 24 to 254), and rectus femoris (mean difference 149 kPa 95 % confidence interval 33 to 265). Higher anterior knee pain provocation severity was associated with lower exercise-induced hypoalgesia at the tendon (Pearson correlation = 0.48; p = 0.011) in participants with Osgood-Schlatter.CONCLUSIONS: Adolescents with Osgood-Schlatter display increased pain sensitivity locally, proximally, and distally but similar endogenous pain modulation compared to healthy controls. Greater Osgood-Schlatter severity appears to be associated with less efficient pain inhibition during the exercise-induced hypoalgesia paradigm.

Introduction: We aimed to describe Quality of life (QoL) among adolescents with Patellofemoral Pain (PFP) and Osgood-Schlatter Disease (OSD) according to the QoL subscale of The Knee injury and Osteoarthritis Outcome Score (KOOS) and the EuroQol 5-dimensions (EQ-5D) and to investigate the characteristics associated with QoL.Methods: This individual participant analysis included data from three clinical trials on adolescents diagnosed with PFP or OSD. We relabeled individual data and constructed a single dataset.Results: We included 323 adolescents with PFP or OSD. Total score of KOOS-QoL was 51±18 and total index score for the EQ5D was 0.67±0.21. KOOS-QoL subscale showed that 59% reported being aware of their knee problems daily or constantly, 37% reported severe to extreme lack of confidence in their knees, 27% reported severe to extreme difficulty with their knees, and 20% reported severely or totally modifying their lifestyle to avoid potentially damaging activities to their knee. EQ-5D showed that 77% experienced problems with everyday activities, 47% reported mobility problems, 17% felt worried, sad, or unhappy, and 7% reported problems looking after themselves. Older participants (age 17-19) reported worse QoL than younger participants. None of the other characteristics were associated with QoL.Conclusions: A high proportion of adolescents with chronic non-traumatic knee pain experience low QoL. More than half were aware of their knee problems at least daily, one in three reported a severe lack of confidence in their knee, and one in six felt worried, sad, or unhappy. QoL was lowest among older adolescents. Introduction We aimed to describe Quality of life (QoL) among adolescents with Patellofemoral Pain (PFP) and Osgood-Schlatter Disease (OSD) according to the QoL subscale of The Knee injury and Osteoarthritis Outcome Score (KOOS) and the EuroQol 5-dimensions (EQ-5D) and to investigate the characteristics associated with QoL.Methods This individual participant analysis included data from three clinical trials on adolescents diagnosed with PFP or OSD. We relabeled individual data and constructed a single dataset.Results We included 323 adolescents with PFP or OSD. Total score of KOOS-QoL was 51±18 and total index score for the EQ5D was 0.67±0.21. KOOS-QoL subscale showed that 59% reported being aware of their knee problems daily or constantly, 37% reported severe to extreme lack of confidence in their knees, 27% reported severe to extreme difficulty with their knees, and 20% reported severely or totally modifying their lifestyle to avoid potentially damaging activities to their knee. EQ-5D showed that 77% experienced problems with everyday activities, 47% reported mobility problems, 17% felt worried, sad, or unhappy, and 7% reported problems looking after themselves. Older participants (age 17-19) reported worse QoL than younger participants. None of the other characteristics were associated with QoL.Conclusions A high proportion of adolescents with chronic non-traumatic knee pain experience low QoL. More than half were aware of their knee problems at least daily, one in three reported a severe lack of confidence in their knee, and one in six felt worried, sad, or unhappy. QoL was lowest among older adolescents.

This study aims to conduct a rapid realist review to develop a programme theory that informs the development of an SDM intervention for health-care practitioners and patients with SAPS to use.

Tendinopathy is considered an overuse syndrome which usually results from excessive loading of the tendon during vigorous training activity. There are, however, various causes of this condition other than mechanical causes. This is a case report, in which a 42-year-old male suffered from bilateral plantar fasciitis after treatment with azithromycin for gastroenteritis. Azithromycin-induced tendinitis is a rare side effect, but it is important to know about this and other non-mechanical causes of tendinopathy, and to distinguish them from common mechanical causes in order to optimize treatment.

Adolescent knee pain has a propensity for chronicity, impacting physical activity and health into adulthood. The aim of this study is to investigate prognostic factors in adolescents with knee pain using individual participant data (IPD) meta-analysis. Studies were identified through a systematic search and a collaborative group. We included IPD from prospective studies of adolescents (age 10-19 years) with nontraumatic knee pain (13 studies and 1516 adolescents with 1281 unique participants). Primary outcomes were pain intensity and function (Knee Injury and Osteoarthritis Outcome Score "Sport/Rec" subscale). Primary endpoint was 12 months. Risk of bias was appraised with Quality in Prognosis Studies tool. Harmonised IPD was analysed by multilevel modelling. Fifty-one percent reported knee pain after 12-months. Lower baseline pain frequency was associated with lower pain intensity at 12 months ("less than weekly"; 12 (95% confidence interval [CI] 7-17) and "monthly"; 15 (95% CI 9-22) points lower on a 100-point pain scale, compared with "almost daily pain"). Other factors most strongly associated with 1-year pain prognosis were lower quality of life (30, 95% CI 19-42 points per unit change in the EQ5D index score), female sex (8 points, 95% CI 4-12 higher compared with males), and bilateral pain (7, 95% CI 1-13 points higher pain). Similar factors were associated with function. Body mass index, pain sensitivity, and knee strength were not associated with prognosis of pain or function. Adolescent knee pain is associated with clinically relevant long-term pain and functional deficits. Self-reported characteristics may help identify those at risk of poor prognosis.

Additional file 2.

Additional file 2.

Additional file 1.

BackgroundEach year, 8% of all child and adolescent consultations in general practice are due to musculoskeletal conditions, with pain as the most frequent symptom. Despite the commonality of musculoskeletal pain, limited knowledge exists about care-seeking children and adolescents with musculoskeletal pain. The purpose of this study was to describe characteristics of children and adolescents consulting their general practitioner with musculoskeletal pain.MethodsThis is a cross-sectional study based on the baseline data from the child and adolescent musculoskeletal (ChiBPS) pain cohort study, carried out in 17 Danish general practice clinics. Patients aged 8-19 years with musculoskeletal pain complaints when consulting their GP completed a questionnaire on demographics, physical activity, pain impact, psychosocial factors, and expectations of their general practitioner. Descriptive statistics were used to summarize data. Normally distributed continuous data are described using mean and standard deviations while non-normally data are described using median and interquartile range. ResultsWe included 100 participants (54% female, median age 13 [12-16] years). The most frequent activity limiting pain regions were knee (56%), back (20%), ankle (19%), and neck (13%). The majority (63%) consulted their general practitioner because they were not able to use their body as usual due to pain. At time of consultation the median pain duration was 5 months [3 weeks-1 year]. Above a third were often or sometimes nervous (34%), worried or anxious (33%), and took pain medication when in pain (33%). Pain made it difficult to participate in sport activities at school (79%) and disturbed spare time activities (88%). Pain made it difficult to concentrate (58%) and to fall asleep (38%) and only 38% expected a pain free long-term future.ConclusionThis study demonstrates the bio-psycho-social impact of musculoskeletal pain in care-seeking children and adolescents. Demographics, pain characteristics, psychosocial characteristics, and physical characteristics should be included in addressing children and adolescents with musculoskeletal pain.Trial registrationThe ChiBPS study where the participants in this study are from, was pre-registered before recruitment (ClinicalTrials.gov Identifier: NCT03678922) date: 09.20.18.

Sundhedsstyrelsen udgiver en opdateret vidensbaseret national klinisk retningslinje om behandling af patienter med subakromielt smertesyndrom af mere end en måneds varighed.Skuldersmerter er det tredje mest almindelige muskel-skelet-problem og en hyppig årsag til henvendelser til almen praksis. Retningslinjen præsenterer fire anbefalinger for udvalgte kliniske problemstillinger i det samlede behandlingsforløb inden for følgende områder:TræningsindsatserBehandling med glukokortikoid injektionPladsskabende operation under skulderhøjen (subakromiel dekompression) ved smerter i mindre end 6 månederSubakromiel dekompression ved symptomer i mere end 6 måneder og manglende effekt af et superviseret træningsforløbMed publicering af denne retningslinje udgår en tidligere retningslinje om skuldersmerter fra 2013. Den nye retningslinje ser udelukkende på behandling af skuldersmerter, hvor den tidligere retningslinje, også indeholdt nedslagspunkter om diagnostik, behandling og rehabiliteringLigeledes udgår Sundhedsstyrelsens faglige visitationsretningslinjer fra 2011 vedrørende udvalgte skulderproblemer, impingementsyndrom/rotator cuff-syndrom og traumatisk rotator cuff-ruptur, da disse retningslinjer ikke understøtter den nye kliniske retningslinje.

Additional file 1.

Supplemental Material, sj-pdf-1-ojs-10.1177_23259671211022239 for Is the Prognosis of Osgood-Schlatter Poorer Than Anticipated? A Prospective Cohort Study With 24-Month Follow-up by Sinead Holden, Jens Lykkegaard Olesen, Lukasz M. Winiarski, Kasper Krommes, Kristian Thorborg, Per Hölmich and Michael Skovdal Rathleff in Orthopaedic Journal of Sports Medicine

Additional file 3.