Updated: 5/29/2017

Sinding-Larsen-Johansson Syndrome

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Introduction
  • Overuse injury causing anterior knee pain at the inferior pole of patella at the proximal patella tendon attachment
    • similar to Osgood-Schlatter's disease which is at the distal attachment of the patella tendon
    • differnt from Jumper's Knee which is tendonitis of the patella tendon
  • Epidemiology
    • demographics
      • more common in adolescence
    • Location
      • patellar tendon insertion at the inferior pole of the patella
  • Pathophysiology
    • chronic injury
    • similar pathogenesis to Osgood-Schlatter
    • overuse causes a traction apophysitis
Classification
 
Blazina Classification
Stage 1 Pain occurs after activity
Stage 2 Pain present while performing activity and persists after activity
Stage 3 Pain affecting/limiting function during activity
 
Presentation
  • History
    • insidious onset of pain on anterior aspect of knee after or during activity
  • Physical exam
    • tenderness over inferior patella
    • swelling
Imaging
  • Radiographs
    • recommended views
      • AP and lateral of knee
    • findings
      • may be normal
      • may show spur at inferior pole of patella
  • MRI
    • indications
      • if diagnosis unclear
    • views
      • inflammation best seen on T2 sagitals
      • bony spurs best seen on T1 sagitals 
Treatment
  • Nonoperative
    • activity modifications, NSAIDS, physical therapy
      • indications
        • mainstay of treatment
        • usually a self limiting process
  • Operative
    • debridement of damaged tissue/stimulation of healing response
      • in some cases refractory to nonoperative treatment
 

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