In Osgood-Schlatter disease, which diagnostic test can be used?

• A. MRI
• B. X-ray
• C. Ultrasound
• D. CT scan

Answer: (B)

Imaging in growing children with knee pain is used to confirm a traction apophysitis at the tibial tubercle and to rule out other conditions. The standard initial test is plain radiographs of the knee. X-ray can reveal fragmentation or irregularity of the tibial tubercle characteristic of Osgood-Schlatter disease, helping to support the diagnosis and track changes over time. It’s widely available, inexpensive, and involves relatively low radiation compared with other options.

MRI, while more sensitive for detecting bone marrow edema and soft-tissue involvement, is usually reserved for atypical cases, persistent symptoms, or pre-surgical planning, not for routine diagnosis. Ultrasound can show soft-tissue changes and fragmentation in some stages, but it is more operator-dependent and less consistent for diagnosing the bony changes. CT provides detailed bone anatomy but involves higher radiation and is not routinely needed for this condition.

So plain X-ray is the most appropriate initial diagnostic test.