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Knee Pain

Sinding Larsen Johansson Syndrome

Minute Read


Posted 9 months ago


Last updated: 29/11/2022


by James McCormack

What is Sinding Larsen Johansson Syndrome?

Sinding Larsen Johansson syndrome is a painful condition of inflammation at the lower patella growth plate. The growth plate at the inferior patella pole becomes inflamed, swollen and painful. A growth plate is an area of bone where most growth occurs in children. They are described as open, when the bone is still growing, and close when there is no more growth. This typically happens towards the end of puberty, for boys this will happen around 13-15years old and slightly later for girls typically between 15-17 years old. Therefore, Sinding Larsen Johansson syndrome only occurs in children and teenagers, most commonly between the age of 10 and 14 years.

Sinding Larsen Johansson syndrome is more common in active youngsters. The greater the exertion placed on the quadriceps muscle the more stress is applied to the patellar growth plate. After enough stress is applied micro damage will occur and if this persists Sinding Larsen Johansson syndrome will develop. Inflammation of a growth plate is known as apophysitis, Sinding Larsen Johansson syndrome is patellar apophysitis. A similar injury to the growth plate of the top of the shin bone is known as Osgood-Schlatter, this is tibial tubercle apophysitis.

Picture of Location of Sinding Larsen Johansson Syndrome Pain

What Signs or Symptoms Distinguish Sinding-Larsen Johansson Syndrome?


  • Pain localised to the lower part of the knee cap
  • Swelling at the front of the knee cap
  • Pain when running, jumping, or walking upstairs
  • Pain when kneeling or squatting
  • Pain and stiffness to bend the knee fully

How is Sinding-Larsen Johansson Syndrome Diagnosed?

A healthcare professional such as a family doctor or physical therapist will ask about the symptoms and history of the development of this injury. They will then carry out a physical examination to assess exactly where the pain is and if they can reproduce the symptoms with the common aggravating movements, such as stretching the quadriceps, squatting or jumping.

If there is any doubt over the diagnosis, imaging might be requested to confirm the clinical diagnosis.

Photo of Child with Sinding Larsen Johansson Syndrome

Radiology for Sinding-Larsen Johansson Syndrome

While radiology in not always necessary there are three forms of imaging can provide information for suspected Sinding Larsen Johansson syndrome:


While x-ray is the least sensitive form of imaging for Sinding Larsen Johansson syndrome, it will usually be able to rule out a fracture, or stress fracture, of the patella or shin bone, which might give similar symptoms.



MRI imaging of Sinding Larsen Johansson syndrome can show more information. It can show bones and the health of the soft tissues, including the patellar tendon which inserts into the patella growth plate. An MRI of suspected Sinding Larsen Johansson syndrome image will show inflammation which can indicate the injury to the growth plate.



Ultrasound is the most informative, cost-effective and the least invasive imaging technique for Sinding Larsen Johansson syndrome. It can also be a less stressful assessment for a child as there is no need to lie still for long periods, and due to the lack of radiation the parent can be with them throughout. The scan can be done dynamically and explained by the healthcare professional as they move the knee and assess the area.


Child playing football after recovering from Sindig Larsen Johansson Syndrome

How Long Does Sindig-Larsen Johansson Syndrome Last?

As Sinding Larsen Johansson syndrome is an issue with the growth plate, it will recover once the child or teenager had stopped growing. However, if activity is appropriately reduced and the knee rested, and if the correct treatments and exercises are followed a child who is still growing can become pain-free. The time for recovery of symptoms of Sinding Larsen Johansson syndrome depends on the severity. It can take a minimum of several weeks of slightly reduced activity, up to 16 weeks of significant activity reduction. It is only in a few very rare cases complete immobilisation is required.

Physiotherapy with James McCormack

This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments for £45.

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