Osgood-Schlatter disease with atypical pain radiations in an adolescent: Exploring the role of benevolent parental diagnostic neglect

Osgood-Schlatter disease, although generally benign, can evolve toward complex chronic forms in cases of diagnostic delay, particularly in African contexts where access to specialized care is limited. To our knowledge, radiating pain to both ankle and inguinal regions has not been previously documented in Osgood-Schlatter disease (PubMed, Embase, Google Scholar search 2000-2025). We report such a case and explore the role of "benevolent parental neglect" as a potential contributor to delayed diagnosis. We report the case of a 14-year-old adolescent presenting with chronic bilateral Osgood-Schlatter disease evolving since childhood, complicated by atypical pain radiations toward the ankle and inguinal fold—a presentation not identified in our literature search. The 7-year diagnostic delay is attributed to "benevolent parental neglect," with parents initially interpreting complaints as "childhood whims. An integrative approach combining hospital-based osteopathy (80%) with gentle pediatric techniques, formal medical prescription, and coordinated distance self-rehabilitation (20%) was implemented. Reinforced parental involvement and follow-up were maintained over 3 months. Clinically meaningful improvements were observed in pain (VAS 7/10 to 3/10) and knee flexion (90° to 130°) after 3 months of integrative treatment. Parental compliance reached 95%, enabling a return to normal activities. This case suggests four exploratory concepts for further investigation: benevolent parental neglect, compensatory biomechanical cascade, integrated hospital osteopathy, and morpho-functional risk profile. These hypothesis-generating observations from a single case may offer a preliminary framework for understanding complex presentations in resource-limited settings. The integrated hospital osteopathy protocol warrants validation through controlled studies.