Sinding Larsen-Johansson Syndrome (SLJS) is classified as a repetitive overuse injury leading to juvenile osteochondrosis and traction apophysitis.1,2 SLJS typically occurs in the adolescent population between the ages of 10-14 and may occur during a growth spurt.1,2 This syndrome can be diagnosed with radiographic imaging showing fragmentation of the patellar pole (distal/bottom of the patella).1 One may also experience swelling, pain and tenderness, at the distal pole of the patella leading to functional limitations.1 If gone untreated, this acute injury can become chronic which causes calcification at the distal pole of the patella and possible life-time impairments. It is important to make an appointment with your Physician to rule out other possible diagnosis such as Osgood-Schlatters Disease (OSD), Jumpers knee syndrome, Bursitis, Iliotibial Band syndrome, and patellofemoral pain syndrome to name a few.1
If you are experiencing distal patellar pain and are diagnosed with SLJS, your physician may resort to prescribing anti-inflammatory medication, Physical Therapy, and possibly a local corticosteroid injection – for pain reduction and conservative treatment/management.2 Once at Physical Therapy, you can expect a thorough examination of you flexibility, strength, and stability. Your physical therapist will then educate you on appropriate exercise/activity modification guidelines, along with recommending exercises to address your impairments and functional limitations. Some exercises may include addressing your leg and hip flexibility and strength (hamstring, gastroc, and quadriceps) along with core strength and stability.
If your child is complaining of anterior knee pain, seek medical attention. If managed appropriately, your child can return to the activities and sports they love most. Contact your physician or physical therapist to begin your road to recovery.
References
- Draghi F, Danesino GM, Coscia D, Precerutti M, Pagani C. Overload syndromes of the knee in adolescents: Sonographic findings. J Ultrasound. 2008;11(4):151-7.
- Medlar, R. C., et al., ‘Sinding-Larsen-Johansson Disease. Its Etiology and Natural History’, Journal of Bone & Joint Surgery, December 1978, vol. 60, no. 8, p. 1113-1116. (Level of Evidence 1B)