Sinding Larsen Johansson Syndrome

Sinding-Larsen and Johansson syndrome

Synonyms: Most commonly known as Jumper's knee, but is also known medically under several different conditions such as apophysitis of the distal pole of the patella, patellar osteochondrosis, adolescent patellar chondromalacia, juvenile osteopathia patellae, osteochondritis patellae juvenilis or distal patella apophysitis.

Etiology:  SLJ is an overuse syndrome that affects the proximal attachment of the patellar tendon into the inferior patellar pole. It is caused by microtrauma to this area and can be followed by calcification and ossification if the condition becomes chronic.  It typically affects children and adolescents between the ages of 10 and 15 y.o. especially when they go through growth spurts.  However, it can also affect active adults who run for moderate to long distances or are involved in sports that require much jumping or squatting. It is similiar to Osgood-Schlatter's disease of the distal patellar tendon.

Typical Signs and Symptoms: US or MRI imaging may show osseus fragmentation of the distal patellar pole, or it may be irregular, with chondral changes and thickening at the insertion of the patellar tendon. Any activity, from normal walking to climbing stairs, may increase the person's pain depending upon the severity of the condition. In less severe cases, a person may not begin to feel pain until after extended activity, such as running for several miles. Tenderness to touch, limping and a tender bump in the infrapatellar area are all common signs. Lower extremity neurovascular signs or crepitus in the knee are rare and may be indicative of another pathology.

Physical Therapy Treatment: First and foremost, physical therapists must educate the patient on activity modification.

Core strengthening, orthotics, Referral to an MD for prescription of antiinflammatories