Sinding-Larsen-Johansson disease

Background

• Knee pain
• Probably traumatic (traction injury) origin
• Closely related to Osgood-Schlatter's

Clinical

• Children and adolescents 10-14 years
• Knee pain aggravated by activity
• Tenderness and soft tissue swelling over the inferior pole of the patella

Investigations

• X-ray - osseous fragmentation at lower pole patella
• NOT an apophysitis or osteochondritis
• Patellar fracture or avulsion infrequent
• The calcifications are usually incorporated into the inferior pole of the patella, and the natural course of the condition is 3-12 months

Management

• Treated symptomatically
• Also responds to quads strengthening exercises
• Rarely, debridement of patellar tendon needed
• No need follow up x-ray in most

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