Children's Hospital Colorado

Sindig-Larsen-Johannson Disease

What is Sindig-Larsen-Johannson disease?

Sindig-Larsen-Johannson disease refers to a condition that causes pain, swelling and soreness on the knee cap (patella). The medical term for this condition is patellar "apophysitis." It occurs directly on the lower part of the knee cap during pre-adolescent development when the growing kneecap is vulnerable to overuse.

Who gets Sindig-Larsen-Johannson disease?

Sindig-Larsen-Johannson only occurs during a certain period of pre-adolescence, when the knee cap is going through a rapid growth spurt. In girls, this typically occurs around 8 to 10 years old, and in boys, around 9 to 11 years old.

The condition is more common in active, athletic children. Children and young athletes who are involved in a lot of running and jumping activities are at higher risk for developing Sindig-Larsen-Johannson due to increased pulling of the kneecap tendon on this growing area.

What are the signs and symptoms of Sindig-Larsen-Johannson disease?

Young athletes with this condition complain of pain with activity and tenderness in the front of the knee, specifically on the lower tip of the knee cap. There may be mild swelling and warmth, and the area can be painful to touch. The pain and swelling often improve with rest.

How is Sindig-Larsen-Johannson disease diagnosed?

Doctors at Children's Hospital Colorado diagnose Sindig-Larsen-Johannson based on a child or young adult's symptoms, physical examination and occasionally an X-ray of the knee. Signs of Sindig-Larsen-Johannson include activity-related knee pain in patients within the typical age group where the bone is growing rapidly (adolescence). A doctor's exam usually reveals tenderness and swelling over the lower part of the kneecap.

How is Sindig-Larsen-Johannson treated?

Sindig-Larsen-Johannson is treated mainly by controlling the pain. This condition can be frustrating, as the child is prone to this pain during the entire length of the growth spurt (usually about two years). Once the growth spurt is over, the pain should resolve. Sindig-Larsen-Johannson is difficult to prevent completely, but changing the type and the amount of activity will help control the pain.

In the meantime, your child may choose to participate in fewer activities or lower-impact activities to avoid pain. Rest should be encouraged based on the pain, but your child should be allowed to return to activity once the pain is under control.

Placing ice over the area of pain after activity can be helpful. For severe pain, over-the-counter pain medicine (such as acetaminophen or ibuprofen) may also be considered. Stretching the muscles around the knee – such as the quadriceps, hamstrings and calf muscles – is highly recommended. Wearing a knee brace can also be helpful for some patients.

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