O
occupational therapy A therapeutic approach to
teach people the skills they need for living as inde-
pendently as possible with long-term injury or dis-
ability. Occupational therapy focuses on
techniques and devices to make easier the activi-
ties and events of daily living, aiding with such
circumstances as recovery after STROKE, develop-
mental disability in children, and rehabilitation
after serious injury or surgery. The doctor may
also recommend occupational therapy for people
who have neuromuscular disorders, MYOPATHY,
NEUROPATHY, and CHRONIC PAINsyndromes. Occupa-
tional therapists also conduct home visits to rec-
ommend environmental adaptations to reduce the
risk of falls as well as to accommodate factors such
as wheelchair accessibility. In the United States
occupational therapy services require a prescrip-
tion from a doctor.
See alsoPHYSICAL THERAPY; QUALITY OF LIFE.
Osgood-Schlatter disease A disorder of the epi-
physis (growth plate) of the tibia, the long BONEin
the lower leg (shin bone) that typically develops in
athletically active adolescents. ADOLESCENCEis the
period during which growth of the long bones is
very rapid. The patellar TENDONstretches across the
head of the tibia to attach at the top of the tibial
tubercle. Athletic activities that extensively use the
quadriceps MUSCLEin the thigh, such as basketball,
place considerable pressure on the tendon insertion
point. In Osgood-Schlatter disease, sometimes
called jumper’s knee, tiny fragments of developing
bone tissue pull away from the epiphysis and
become embedded in the tendon. As these frag-
ments, called avulsion fractures, mineralize they
form a hard lump just below the patella (kneecap).
The main symptoms of Osgood-Schlatter dis-
ease, also called osteochondrosis, are a noticeable
lump and PAINin the area of the knee. Pain is
often more intense when going up and down
steps, running, and jumping. Osgood-Schlatter
disease tends to affect girls at a younger age (10 to
12 years) than it affects boys (12 to 14 years). The
doctor bases the diagnosis on the presentation of
symptoms and the findings on X-RAYstudies. The
doctor may also conduct a bone scan when the X-
ray findings are unclear. However, diagnosis is
usually straightforward.
Osgood-Schlatter disease is self-limiting; it goes
away when growth in the tibia ceases. Ice to the
area and NONSTEROIDAL ANTI-INFLAMMATORY DRUGS
(NSAIDS) to relieve INFLAMMATIONand pain are gen-
erally sufficient treatment. A physical therapist or
sports medicine specialist can teach the child
stretching exercises for the quadriceps and for the
hamstrings, in the back of the thigh, to reduce
pressure against the patellar tendon.
See also ATHLETIC INJURIES; PHYSICAL THERAPY.osteoarthritis A condition of progressive degen-
eration of the joints. Osteoarthritis tends to
develop in adults age 60 and older and to affect
joints subject to excessive stress throughout life,
often in occupational settings. Recreational and
athletic activities may also result in osteoarthritis.
The fingers, cervical spine (neck), knees, hips, and
lumbar spine (low back) are most commonly
affected. About 20 million Americans have
osteoarthritis.
Osteoarthritis damages CARTILAGE, the thin layer
of smooth connective tissue that coats the ends of
bones with the joints. Cartilage is so dense that it
does not have its own BLOODsupply. Instead, it
relies on adjacent tissues and the synovial fluid to
supply it with the NUTRIENTSit requires. Cartilage
cannot regenerate or rebuild itself so damage to it341