Sinding-Larsen-Johansson syndrome

This condition refers to a problem with the region where the patella tendon joins the bottom of the patella in a growing adolescent. Near to the end of growth the muscles and tendon become stronger than this area of growing bone, and in some individuals the repeated pulling on the bone can cause problems with separation of the growing bone and fragmentation. When the femur is growing fast it can make the quadriceps muscles tight and this can exacerbate the problem.

The acute phase of this condition affects teenagers, who will experience pain where the patellar tendon attaches to the patella. There is tender spot at the bottom of the kneecap which can be sore to touch. Adults may have had this condition without it ever being diagnosed and been left with the lump which can make it hard to kneel down.

If you think you or your child has this condition it is well worth getting it checked out by Mr Willis-Owen. It is usually 'self limiting' meaning that you will grow out of it, but there a number of things to do to minimise the discomfort.

Treatment involves first confirming the diagnosis, this usually needs X-rays. Physiotherapy can sometimes help to stretch out tight quads and careful activity modification is required to keep the discomfort to a minimum while the condition resolves. Rarely if pain persists after growth is finished surgery is needed to remove loose pieces of bone.