To our knowledge, no study on Osgood-Schlatter disease has been previously done in Togo. The available national data concern rheumatic diseases in children in general [5-6].

Osteochondrosis is a non-infectious disease that causes abnormal ossification of secondary bone nuclei [7]. 7] Of these, those that affect the apophyses are called apophysoses [7]. Apophysoses are a frequent reason for consultation in children [1,3,7]. Osgood-Schlatter disease is the apophysosis of the anterior tibial tuberosity [1-2,7].

The diagnosis of Osgood-Schlatter disease is relatively easy. The diagnosis is mainly based on clinical findings [1-3,7]. The disease peaks in adolescence during the growth spurt and is most common in males [2-3,7]. Clinically, it is associated with mechanical pain in the anterior aspect of the knee, triggered, maintained and aggravated by exercise and calmed by stopping the exercise and resting [3,7]. Inspection may reveal a prominent ATT and palpation of the ATT is painful [3,7]. This pain may also be caused by the active knee extension manoeuvre [3,7]. Although radiography is the imaging test of choice, it only contributes to a positive diagnosis in rare cases [2-3,7]. It is only used for atypical forms and to eliminate differential diagnoses [1-2,7]. Radiographic abnormalities in Osgood-Schlatter disease include: prominence of the ATT, soft tissue enlargement, fragmentation of the opacification nucleus; the latter may exist physiologically [1,3,7]. Our patient presented with fragmentation of his 2 anterior tibial tuberosities.

The etiopathogenesis of Osgood-Schlatter disease is poorly understood [2-3,7]. A disturbance in endochondral ossification during growth may be the cause [7]. Several authors have reported a multifactorial origin [7]. The microtraumatic component due to overloading remains the most widely described factor [2-3,7].

Conservative treatment is the first line of treatment. It is mainly based on a functional approach [7]. It is based on rest, analgesics and anti-inflammatories [2]. No ideal duration of rest has been reported in the literature. In our case, it was 3 weeks simply for convenience. Surgery has only limited indications [3-4]. It is reserved for complicated forms and hyperalgesic manifestations of the disease [3].

The prognosis is usually favourable, with recovery occurring without sequelae at the end of growth [3,7]. However, this condition is associated with certain complications [3-4,7-8]. We can cite retraction of the hamstrings or the sural triceps, patella alta, genu recurvatum and patellofemoral osteoarthritis [7-8]. Knowledge of this condition is therefore essential for early diagnosis and, above all, for appropriate treatment.

The delay in the diagnosis of our patient was 14 months.  The case was reported in the Regional Hospital of Dapaong in Togo. This hospital has an insufficient number of qualified personnel. The whole region has neither a rheumatologist nor a paediatric surgeon. Consultations are carried out by doctors but in most cases by medical assistants and nurses.