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Osgood-Schlatter disease is an orthopedic problem that commonly affects children between the ages of 11 and 14 years. It involves the leg just below the knee cap where the tendon inserts into a boney prominence, the tibial tubercle. It has been attributed to a problem with bone growth and development. However, recent evidence based on magnetic resonance imaging (MRI) scans suggests it may be a form of tendon inflammation. In any event, the symptoms are primarily pain in the affected area and swelling just below the knee cap. It may occur on both legs. Fortunately, the problem usually does not require extensive x-rays or other diagnostic tests and disappears later in adolescence without treatment. Pain may require that your nephew reduce strenuous physical activity but there is rarely any long-term discomfort or significant disability.