Case of the Week: March 24-March 31, 2006

11 year old boy with knee pain

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Case Details

Answer

Diagnosis: Sinding-Larsen-Johansson (SLJ) Disease

  • Pain, swelling, tenderness of inferior patellar pole at origin of the patellar tendon
  • Osteochondrosis involving the apex of the patella
  • 10-14 years
  • Traction phenomenon - tendonitis proximal patellar tendon
  • Calcification and ossification on elongated inferior patellar pole
  • Natural duration of the disease is approximately 3 to 12 months

                                                Osteonecrosis

    SiteNameAge (years)Frequency
    LunateKienbockAdultRare
    Femoral headLegg-Calve-Perthes4-10+++
    Inferior patellaSinding-Larsen-Johansson8-12+
    Tibial tubercleOsgood-Schlatter10-15 ++
    Proximal medial tibial condyleBlount2-14+
    Calcaneal apophysisSever5-15rare
    Tarsal navicular Kohler4-8++
    Vertebral apophysesScheuermann10-18++

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VCU Department of Pediatric Radiology Virginia Commonwealth University VCU Medical Center