Patellar sleeve avulsions psa are rare injuries that occur in children and adolescents, and represent less than 1% of all pediatric fractures 1, 2. It is often referred to as jumpers knee and coincides with growth spurts. It can also be used for severs disease and sindinglarsenjohansson syndrome. Sindinglarsenjohansson disease radiology reference. Sindinglarsen johansson disease slj is a possible cause of knee pain in 8toyearold active individuals. It is not osteonecrosis, epiphysitis or osteochondritis as previously described in the literature. A rare occurrence of sindinglarsen johansson syndrome with osgoodschlatter disorder in a nigerian child. It is a closely related condition to osgoodschlatter disease. The sindinglarsenjohansson syndrome is caused by increased tension and pressure due to repetitive traction by the patellar tendon on the lower pole of the patella still partly cartilaginous in adolescents during.
Although symptoms of sinding larsen johansson syndrome may linger for months, few patients have poor outcomes with conservative treatment, and surgical intervention is generally not necessary. Sindinglarsenjohansson disease the free dictionary. Pdf sinding larsen johansson slj syndrome is a type of osteochondrosis of the distal pole of the patella most often caused by repeated microtrauma find, read and cite all the research. This is an irritation of the growth plate at the bottom of the kneecap. An abnormal condition of a part, organ, or system of an organism resulting from various causes, such as infection, inflammation. Some diseases are acute, producing severe symptoms that. It is an osteochondrosis of the distal patella, secondary to excessive traction caused by the extensor mechanism. This may be inflammation of the cartilage of the growing patella, death of tendon cells from repeated stress, or pulling off of the lining of the patellar bone. Mar 28, 2012 sinding larsen johansson syndrome was diagnosed and the patient was told to refrain from sports activity, which was a difficult task in this particular case. Osgoodschlatter and sindinglarsenjohansson syndrome are common conditions in. Sinding larsen johansson syndrome slj and osgood schlatter disorder osd are osteochondroses. Sindinglarsenjohansson disease synonyms, sindinglarsenjohansson disease pronunciation, sindinglarsenjohansson disease translation, english dictionary definition of sindinglarsenjohansson disease. It is caused by swelling and irritation of the growth plate there.
In comparison, a sleeve fracture is a traumatic separation of the distal articular. Sinding larsen johansson disease synonyms, sinding larsen johansson disease pronunciation, sinding larsen johansson disease translation, english dictionary definition. Robert bernstein md chief of pediatric orthopedics surgery cohen childrens hospital, orthopedic residency massachusetts general hospital, fellowship ped. It goes over the patella and is attached to the tibial tuberosity. The adult equivalent of this disease is patellar tendinitis. Sinding larsen johansson syndrome pain free physiotherapy. Sinding larsen 1 reported an affection of the distal pole of the patella in two adolescents based on a lecture by johansson, who was the first to describe the disease. Acupuncture meridianbased myofascial release to treat knee. In cases of painful sindinglarsenjohansson syndrome that are recalcitrant to conservative treatment, arthroscopic excision of the distal pole of the patella is an effective procedure that allows the tendon to be checked and return to sports within a few months.
Sinding larsen johansson disease is a self limiting condition that gradually resolves as the patient moves towards skeletal maturity. Pdf arthroscopic treatment of painful sindinglarsen. Sindinglarsenjohansson syndrome south african journal of. The peak incidence of sleeve fractures in children is 12. Sinding larsen johansson syndrome results from stress a single sudden incident or repeated or injury of the lower patella that interferes with development, causing inflammation. Sinding larsen johansson slj syndrome is a painful knee condition that most commonly affects teens during periods of rapid growth. Sindinglarsenjohansson childrens hospital colorado. Pe26 sindinglarsenjohansson syndrome seattle childrens.
Adolescents who participate in sports involving running, twisting and jumping such as basketball, football, and gymnastics etc are more prone to this condition. Sindrome sindinglarsen johansson linkedin slideshare. Sinding larsen johansson slj disease is an overuse injury of the knee commonly seen in growing, active adolescents between the ages of 11 and 15 years. Find out information about sindinglarsenjohansson disease. The patellar ligament or tendon is the distal part of the tendon of the m. Sinding larsen johansson syndrome is a selflimiting syndrome. These images are a random sampling from a bing search on the term sinding larsen johansson disease. Here is where i do my best to explain what sindinglarsenjohansson slj syndrome is remember i am not a doctor, nurse, nor have i.
Sinding larsen johansson syndrome slj is a juvenile osteochondrosis and. Your kneecap, or patella, is connected to your shinbone tibia by the patellar tendon. The sindinglarsenjohansson syndrome has a pathogenesis similar to that of the osgoodschlatter disorder and is the result of excessive. Sindinglarsenjohansson syndrome results from stress a single sudden. Sindinglarsenjohansson syndrome is a selflimiting syndrome. Sindinglarsen johansson disease, first described in 1921, is one of the osteochondroses.
Sindinglarsen johansson disease definition of sinding. It is analogous to osgoodschlatter disease which involves the upper margin of the tibia. Injuries and conditions of the extensor mechanism of the. Sindinglarsenjohansson disease is a self limiting condition that gradually resolves as the patient moves towards skeletal maturity. The sinding larsen johansson syndrome has a pathogenesis similar to that of the osgoodschlatter disease and the two disorders sometimes occur simultaneously.
Sinding larsen johansson syndrome is an osteochondrosis of the inferior pole of the patella and is often bilateral. A hitherto unknown affection of the patella in children. Us image shows swelling of the cartilage, fragmentation of the lower pole of the patella, patellar tendon. From outside the hospital, call the tollfree family interpreting line. The symptoms rapidly regressed and after 5 months the patient had completely recovered and us followup revealed no anomaly. Patellar sleeve avulsion fracture in a patient with. It represents a chronic traction injury of the immature osteotendinous junction. Sindinglarsenjohansson slj syndrome is a type of osteochondrosis of. A growth plate is a layer of cartilage near the end of a bone where most of the bones growth happens. Rectus femoris, part of the quadriceps femoris, which is a continuation of it. Sindinglarsenjohansson slj syndrome is a painful knee condition that most commonly affects teens during periods of rapid growth. The strickland protocol is the only proven treatment in the world today to treat and cure osgood schlatters disease.
Sinding larsen johansson syndrome commonly affects adolescents and young boys who are physically active during their growth spurts. Pdf sindinglarsenjohansson slj syndrome is a type of osteochondrosis of the distal pole of the patella most often caused by repeated microtrauma find, read and cite all the research. Acupuncture meridianbased myofascial release to treat. Sindinglarsenjohansson disease slj, also known as sinding larsen disease or larsen johansson syndrome, affects the proximal end of the patellar tendon as it inserts into the inferior pole of the patella it represents a chronic traction injury of the immature osteotendinous junction. Sindinglarsenjohansson disease childrens orthopaedic and. Free interpreter services in the hospital, ask your nurse. It begins superiorly at the anterior inferior iliac spine aiis and extends distally. Knee sindinglarsenjohansson syndrome treatments patellar tendon strap home recovery wearing a patellar tendon strap, which is designed to reduce inflammation of the patellar tendon and keep the kneecap aligned correctly, can help in the treatment. It is an osteochondrosis of the distal patella, secondary. Osgoodschlatter and sindinglarsen syndrome fit to play. Sindinglarsen and johansson syndrome, named after swedish surgeon sven christian johansson 18801959, and christian magnus falsen sindinglarsen 18661930, a norwegian physician, is apophysitis of the inferior pole of the patella. Sindinglarsenjohansson syndrome is an osteochondrosis of the inferior pole of the patella and is often bilateral. Case discussion it is an osteochondrosis caused by chronic avulsion injury common between the ages of 1012 years.
Tony was a star sprinter on the track and field team at his middle school, but in high school it seemed like his friends matured earlier and surpassed him. Although symptoms of sindinglarsenjohansson syndrome may linger for months, few patients have poor outcomes with conservative treatment, and surgical intervention is seldom necessary. The thigh muscles and tendon can become very tight and cause stress on the knee cap. Sindinglarsenjohansson disease article about sinding. Causes and symptoms of sinding larsen johansson disease. Severs disease is an analogous condition affecting the achilles tendon attachment to the heel. Signs of sindiglarsenjohannson include activityrelated knee pain in patients within the typical age group where the bone is growing rapidly adolescence. The sindinglarsenjohansson syndrome has a pathogenesis similar to that of the osgoodschlatter disorder and is the result of excessive force exerted by sindinglarsenjohansson syndrome. It is weaker and more at risk for injury than the rest of the bone. Most reported cases of psa involve the inferior patellar pole, but less frequent bilateral and superior pole fractures have also been reported 3, 4.
Sindinglarsen johansson disease slj sports medicine. The extensor mechanism of the knee is an integral and vital part of normal function of the lower extremity. The sindinglarsen johansson syndrome is a rupture or avulsion of the patellar ligament at the distal point of the patella caused by traction. Arthroscopic treatment of painful sindinglarsenjohansson. Children often complain of pain and swelling at the bottom of the knee cap that may be worsened by climbing stairs, running, jumping, deep bending of the knee, or kneeling. Care of the young athlete, 2nd edition, harris ss, anderson sj eds, american academy of orthopedic surgeons and american academy of pediatrics, elk grove village 2010. Doctors at childrens hospital colorado diagnose sindiglarsenjohannson based on a child or young adults symptoms, physical examination and occasionally an xray of the knee. Sep 17, 2018 sinding larsen johansson syndrome commonly affects adolescents and young boys who are physically active during their growth spurts.
Click on the image or right click to open the source website in a new browser window. Find out information about sinding larsen johansson disease. To our knowledge, there are no case reports of inferior pole psa with prior slj syndrome published in literature. Sindinglarsenjohansson syndrome was diagnosed and the patient was told to refrain from sports activity, which was a difficult task in this particular case. Sinding larsen johansson syndrome presents in growing boys and girls as.
Complete recovery can be expected with closure of the patella growth plate. Your child is diagnosed with sindinglarsenjohansson syndrome. Patellar sleeve avulsion fracture in a patient with sinding. Irregular calcifications of the proximal insertion of the patellar tendon in keeping with sindinglarsenjohansson disease. Complete recovery can be expected with the closure of the patella growth plate. Sinding larsen johansson slj syndromesignssymptoms. He started training extra hard to make up the ground he felt hed lost. Sindinglarsenjohansson syndrome south african journal. Knee sindinglarsenjohansson syndrome treatments bracing and immobilization home recovery depending on your level of activity and on the degree of pain and discomfort you are experiencing from sindinglarsenjohansson slj syndrome, your doctor may suggest that you wear a protective knee brace or a light cast. A case report article pdf available january 2019 with 169 reads how we measure reads. The sinding larsen johansson syndrome is caused by increased tension and pressure due to repetitive traction by the patellar tendon on the lower pole of the patella still partly cartilaginous in adolescents during. Sindinglarsenjohansson disease slj, also known as sindinglarsen disease or larsenjohansson syndrome, affects the proximal end of the patellar tendon as it inserts into the inferior pole of the patella it represents a chronic traction injury of the immature osteotendinous junction.
These images are a random sampling from a bing search on the term sindinglarsenjohansson disease. Sindinglarsenjohansson syndrome sinding larsen yohanson. This usually takes between 6 to 12 months but may persist for as long as 2 years. Sinding larsen and johansson syndrome, is an analogous condition involving the patellar tendon and the lower margin of the patella bone, instead of the upper margin of the tibia. Sinding larsen johansson syndrome slj is a condition affecting children younger than children affected with osgoodschlatter disease, generally between the ages of seven and thirteen, before adolescence. There is point tenderness at the bonetendon junction, and osgoodschlatter disease may be present. Sindinglarsen johansson syndrome slj and osgood schlatter disorder osd are osteochondroses. Pain free return to sports competition was possible after 5 months. Pain is usually related to activity and is typically over the inferior pole of the patella. Sinding larsen johansson syndrome was diagnosed and the patient was told to refrain from sports activity, which was a difficult task in this particular case. Pain in activities like stair climbing, squatting and kneeling. The mri confirmed his diagnosis, but was worse than he initially thought. The condition is usually seen in athletic individuals typically between 1014 years of age. Sindinglarsen 1 reported an affection of the distal pole of the patella in two adolescents based on a lecture by johansson, who was the first to describe the disease.
Sindinglarsenjohansson syndrome results from stress a single sudden incident or repeated or injury of the lower patella that interferes with development, causing inflammation. Sinding larsen johansson syndrome sindinglarsen and. Both conditions may coexist, resulting in anterior knee pain in a child. Your child is diagnosed with sinding larsen johansson syndrome. Sinding larsen johansson is commonly seen in active adolescents aged between 10 and 14 years, as described in our patient. From outside the hospital, call the toll free family interpreting line, 18665831527. Tell the interpreter the name or extension you need. Sindinglarsenjohansson disease is an irritation of the growth plate at the bottom of the knee cap. This variant was discovered in 1908, during a winter indoor olympic. Sindinglarsen johansson disease slj is a possible cause of knee pain in 8 toyearold active individuals. Treatments welcome to insall scott kelly institute.
Knee sinding larsen johansson syndrome treatments bracing and immobilization home recovery depending on your level of activity and on the degree of pain and discomfort you are experiencing from sinding larsen johansson slj syndrome, your doctor may suggest that you wear a protective knee brace or a light cast. Sindinglarsenjohansson syndrome definition of sinding. Sinding larsenjohansson is commonly seen in active adolescents aged between 10 and 14 years, as described in our patient. Sindinglarsenjohansson syndrome sinding larsen yohanson, apophysitis of the distal pole of the patella. This can occur in growth spurts or overuse from running, jumping or squatting. Sinding larsen johansson disease is an irritation of the growth plate at the bottom of the knee cap. The sindinglarsenjohansson syndrome has a pathogenesis similar to that of the osgoodschlatter disease and the two disorders sometimes occur simultaneously. Although symptoms of sinding larsen johansson syndrome may linger for months, few patients have poor outcomes with conservative treatment, and surgical intervention is seldom necessary. Jan 14, 2015 sinding larsen johansson disease, first described in 1921, is one of the osteochondroses.
Sindinglarsen and johansson syndrome, is an analogous condition involving the patellar tendon and the lower margin of the patella bone, instead of the upper margin of the tibia. Physical therapy or home exercises are an important part of treatment. Local pain, swelling, and tenderness over the tibial tuberosity. Feb 28, 2011 robert bernstein md chief of pediatric orthopedics surgery cohen childrens hospital, orthopedic residency massachusetts general hospital, fellowship ped. Sindinglarsenjohansson slj syndrome is pain at the bottom of the kneecap patella. Sinding larsen johansson disease slj, also known as sinding larsen disease or larsen johansson syndrome, affects the proximal end of the patellar tendon as it inserts into the inferior pole of the patella. This condition called sindinglarsen and johansson syndrome was described independently by sindinglarsen in 1921 and johansson in 1922. Acute presentation of sindinglarsenjohansson disease. Initial treatment consists of medications and ice to relieve pain, stretching. Sinding larsen johansson slj syndrome is pain at the bottom of the kneecap patella. Sindinglarsen johansson disease information page patient.
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