Screening of the Maturity Status of the Tibial Tuberosity by Ultrasonography in Higher Elementary School Grade Schoolchildren

Int J Environ Res Public Health. 2019 Jun 17;16(12):2138. doi: 10.3390/ijerph16122138.


This study aimed to obtain screening data on the maturity status of the tibial tuberosity in schoolchildren of higher elementary school grades for risk management of Osgood-Schlatter disease (OSD). The maturity stages and cartilage thicknesses at the tibial tuberosity were determined by ultrasonography on the occasion of a school-based musculoskeletal examination for 124 grade 5-6 elementary schoolchildren, and their associations with the students' demographic characteristics and OSD were examined. The time-dependent changes of the maturity status of the tibial tuberosity were also examined in grade 5 students (n = 26) by a longitudinal survey. The cross-sectional survey showed that the epiphyseal stage was reached in 89% of girls and 35% of boys. The girls who had experienced menarche (n = 28) were all in the epiphyseal stage and had a decreased cartilage thickness (p = 0.004, after adjusting maturity stages). Students with OSD (n = 5) were all girls in the epiphyseal stage, and only two of them had an increased cartilage thickness. During the longitudinal survey, a marked increase in cartilage thickness from the previous measurement was observed in three boys (without clinical symptoms) and a girl who newly developed OSD. Two students with OSD without chronic pain had thin cartilage. In conclusion, for schoolchildren of higher elementary school grades, the risk of OSD is higher among girls with the epiphyseal stage. Cartilage thickness may not contribute to the diagnosis of OSD, since thick cartilage is not very common in OSD. However, cartilage thickness may reflect the status of OSD.

Keywords: Osgood–Schlatter disease; cartilage thickness; musculoskeletal examination; schoolchildren of higher elementary school grades; tibial tuberosity.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cartilage / anatomy & histology*
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Japan
  • Male
  • Mass Screening / methods*
  • Mass Screening / statistics & numerical data*
  • Osteochondrosis / diagnosis*
  • Osteochondrosis / physiopathology*
  • Sex Factors
  • Students / statistics & numerical data*
  • Tibia / anatomy & histology*
  • Ultrasonography