Sinding - Larson - Johanssen

Epidemiology

 

Active pre teen boy

- activity related pain

- common in high jumpers

 

Diagnosis

 

Fragmentation / calcification of inferior pole

- repetitive traction injury where PT inserts

- tender at this point

 

Stages 

 

I     Normal

II    Ca inferior pole irregularity

III   Coalesce Ca inferior pole

IV    Incorporation of Ca

 

DDx

 

Patella stress fracture

Sleeve fracture

Type 1 bipartite patella

Jumper's knee in older patient

 

Management

 

Self- limiting 

- symptomatic treatment

- can use cast immobilisation

 

Rarely surgical excision