Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands.
Center for General Practice, Aalborg University; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
Br J Gen Pract. 2022 Mar 31;72(717):e301-e306. doi: 10.3399/BJGP.2021.0386. Print 2022 Apr.
Osgood-Schlatter disease (OSD) is a non-traumatic knee problem that is primarily observed in sports-active children and adolescents aged 8-15 years.
To determine the incidence of OSD and to gain an insight into the management of children and adolescents with OSD in general practice.
A retrospective cohort study was conducted using a healthcare database containing full electronic health records of over 200 000 patients in general practice in and around the Dutch city of Rotterdam.
Patients with a new diagnosis of OSD from 1 January 2012 to 31 December 2017 were extracted using a search algorithm based on International Classification of Primary Health Care coding and search terms in free text. Data on the management of OSD were manually interpreted.
The mean incidence over the study period was 3.8 (95% confidence interval [CI] = 3.5 to 4.2) per 1000 person-years in those aged 8-18 years. Boys had a higher incidence rate of 4.9 (95% CI = 4.3 to 5.5) compared with girls (2.7, 95% CI = 2.3 to 3.2). Peak incidence was at 12 years of age for boys and 11 years for girls. Advice was the most commonly applied strategy (55.1%), followed by rest (21.0%), referral for imaging (19.5%), and physiotherapy (13.4%).
To the authors' knowledge, for the first time the incidence of OSD has been calculated using GP electronic medical files. There is a discrepancy, especially for imaging and referral to a medical specialist, between the current Dutch general practice guidelines and how GPs actually manage the condition in clinical practice.
Osgood-Schlatter 病（OSD）是一种非创伤性膝关节疾病，主要发生在 8-15 岁运动活跃的儿童和青少年中。
确定 OSD 的发病率，并深入了解全科医生对 OSD 患儿的管理情况。
本研究使用医疗保健数据库，该数据库包含荷兰鹿特丹市及周边地区 20 多万名患者的完整电子健康记录，采用回顾性队列研究。
使用基于国际初级保健分类编码和自由文本搜索词的搜索算法，从 2012 年 1 月 1 日至 2017 年 12 月 31 日提取新诊断为 OSD 的患者。手动解释 OSD 管理数据。
在研究期间，8-18 岁人群的平均发病率为每 1000 人年 3.8（95%置信区间[CI] = 3.5-4.2）。男孩的发病率高于女孩，为 4.9（95%CI = 4.3-5.5），而女孩为 2.7（95%CI = 2.3-3.2）。男孩的发病高峰在 12 岁，女孩为 11 岁。最常用的治疗策略是建议（55.1%），其次是休息（21.0%）、转诊进行影像学检查（19.5%）和物理治疗（13.4%）。
据作者所知，这是首次使用全科医生电子病历计算 OSD 的发病率。目前荷兰全科医生指南与全科医生在临床实践中实际管理该病的情况之间存在差异，尤其是在影像学检查和转诊给医学专家方面。
