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Had Osgoode-Schlatter's disease. Swelling in her foot. Foot will twitch and spasm randomly and painful. What could this be?

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My 15 year old daughter has had Osgoode-Schlatter's disease since she was about 11. She is finding every time she has a growth spurt it flares up, and she is in the midst of a flare up at the moment. This time though the swelling is worse, its swelled down to her foot, she is noticing her foot will twitch and spasm randomly and becomes painful. What are the spasms? We are also concerned as I have a 6 1/2 year old son with ADHD and behavioural difficulties who when frustrated will purposely hit and try to injure her knee and leg so are also wondering if having it put in a cast or brace would have some validity to protect it and allow it to heal.
Posted Sun, 21 Jul 2013 in General Health
Answered by Dr. Ali Ismayilov 2 hours later
Hello and Welcome,

Osgood-Schlatter disease or syndrome (OSD) is a chronic condition. In most of the cases it is self-limiting although it grow into adulthood in some cases.

Each time during physical activities, kneeling, trauma etc., the condition can flare up showing up with signs of inflammation (redness, pain, swelling). As the actual process is just at the attachment of the tendon to the bone, almost each stress to this area causes microscopic tears. If the stress factor is strong enough, up to avulsion fracture can occur (i.e. superficial layer of the bone can be torn off).

Having said this, the condition that you described seems to be rather serious flare up. Twitching and spasms are most likely the response to the inflammation.

So, your best bet at this time is to see her doctor (who takes care of her knee). While you are awaiting your appointment, do the following:

- Follow R.I.C.E. principle - ask your daughter to REST, apply ICE, COMPRESS the painful joint area (i.e. apply elastic bandage or neoprene knee sleeve), and ELEVATE the leg. Please note: if your daughter's leg feels numb or has tingling sensation, the compressing elastic wrap is too tight - so relax it a bit.
- You may give her one of the pain medications she usually takes (I apologize for not being able to give you particular drug names at this website - we are not allowed).

The symptoms should subside after some time. If they don't by the end of the day, please take her to the ER.

Hope this helps.

Kind Regards,

A. Ismayilov, MD
Above answer was peer-reviewed by
Follow-up: Had Osgoode-Schlatter's disease. Swelling in her foot. Foot will twitch and spasm randomly and painful. What could this be? 9 hours later
Hi Dr Ismayilov,
She has been experiencing this particular flare up for about a week. We took her to a walk in clinic on Monday, and the doctor there put her on Voltoren, and Periot (I know that is used to protect the stomach from the harshness of the Voltoren), and this doctor also advised rest, heat/ice therapy, which we have done, along with a supportive velcro knee brace. I have been the one have to put on the brace, and have made sure it isn't too restrictive, and we also take it off at night, we take it off during the day to give it breaks, and still it seems to swell further, and have these spasms. She saw another Dr who recommended physiotherapy 2 days later, but of course with the holiday weekend, it will take time to start. Would it be imperative to do some kind of intervention to protect her knee, such as a walking cast, or something more protective then the velcro knee brace to protect her knee from 'attacks' from my emotionally volatile son, and my two other small children who seem to accidentally knock it, and bump into it many times, causing her great pain and distress. We do have an appointment to follow up about her knee pain with a nurse practitioner Tuesday morning
Let me know if it seems pressing to do immediately,
Answered by Dr. Ali Ismayilov 11 hours later

In terms of protecting her knee, I would recommend you to take the same measures you always took for her. My major concern is the extent of the inflamed area. So, please tell me the following:
- Does she feel any better as compared to, let's say, a couple of days ago?
- How long do her flare ups usually last?
Kind Regards,
Above answer was peer-reviewed by
Follow-up: Had Osgoode-Schlatter's disease. Swelling in her foot. Foot will twitch and spasm randomly and painful. What could this be? 4 hours later
Hello again Dr Ismayilov,
usually her flare ups last about a week. She reminded me that she also had a bizarre outbreak of the swine flu that resulted in her leg swelling severely for about 2 weeks, which was considered unusual. Her leg is not feeling any better, and is more swollen then her usual flare ups. Her calf feel tight as well, she feels the skin on most of her lower leg is very stretched, as well as her foot.
Thanks for answering us,
Answered by Dr. Ali Ismayilov 19 hours later
OK, I see.
I would then advise you to take her to the ER as soon as possible. In my opinion, you gave this flare up enough time to resolve or at least to get better. So, this issue went beyond the online consultation. Please take her to the ER as soon as possible.

Kind Regards,

A. Ismayilov, MD
Above answer was peer-reviewed by
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