> Sinding-Larsen-Johansson Syndrome
What is Sinding-Larsen-Johansson
(SLJ) syndrome is a painful knee condition centered
around the spot behind the kneecap (patella) at the
origin of the patellar tendon, which is the ligament
that connects your thigh muscle to your lower leg. It
is related to growth and growth spurts, and primarily
affects boys aged 10 to 15 and girls aged eight to 13
who are active in athletics.
Sinding-Larsen-Johansson (SLJ) syndrome
is caused by repeated stress on the inferior patellar
pole, which is located where the patellar tendon inserts
into the kneecap. While growth spurts are a contributing
factor to SLJ, many activities can aggravate the condition.
Sports that require jumping, running, and cutting, such
as soccer, basketball, volleyball, and gymnastics fall
into this category.
can exist simultaneously with Osgood-Schlatter disease,
which also primarily affects adolescents but which produces
pain below the kneecap, where the patellar tendon inserts
into the shinbone (tibia). Rarely, when the condition
is present in adulthood, surgical removal of ossicles
(areas of bone formation within the tendon) is recommended
after all non-operative treatments fail.
There usually are three parts to an
orthopedic evaluation: Medical history, a physical examination,
and tests that your doctor may order.
will likely ask you to describe in detail the nature
of your pain: how acute it is, where it is centered,
when it occurs, and how long it lasts. This will provide
clues that can help determine a treatment program. Physicians
also typically ask about other conditions, such as diabetes
and allergies, and medications currently being taken.
It is particularly important to tell your physician
the extent of your athletic activities and goals, since
Sinding-Larsen-Johansson (SLJ) primarily affects physically
After you have given your medical
history and described your symptoms, your physician
will check for tenderness by applying pressure to the
area while your knee is extended and flexed. Any tenderness
will usually diminish when your knee is flexed to a
90-degree angle and the tendon becomes taut.
An X-ray usually will not show evidence of Sinding-Larsen-Johansson
syndrome, but it can show if there is calcification
(hardening due to calcium deposits) of the inferior
patellar pole, or if the inferior patellar pole has
become elongated. This can confirm the diagnosis, but
does not change the treatment of the condition.