Knee > Sinding-Larsen-Johansson Syndrome

What is Sinding-Larsen-Johansson Syndrome?

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.

Considerations [top]

Sinding-Larsen-Johansson syndrome 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.

Orthopedic Evaluation  

There usually are three parts to an orthopedic evaluation: Medical history, a physical examination, and tests that your doctor may order.


Your physician 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 active adolescents.


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.


   Imaging techniques

Bracing and Immobilization
Quadriceps Strengthening
Patellar Tendon Strap
Non-Steroidal Anti-Inflammatory Drugs

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