From the Research
Patients with Sinding-Larsen and Johansson syndrome typically do not need to be seen by a rheumatologist, as this condition is primarily managed by primary care physicians, sports medicine specialists, or orthopedic doctors rather than rheumatologists. Sinding-Larsen and Johansson syndrome is not an autoimmune or inflammatory joint disease but rather an overuse injury affecting the patellar tendon where it attaches to the lower pole of the patella (kneecap) in growing adolescents, particularly those active in sports involving jumping or running.
Key Points
- The condition is characterized by localized knee pain in physically active adolescents, particularly males, as noted in a scoping review 1.
- Ultrasound and MRI are the most effective diagnostic tools for Sinding-Larsen-Johansson disease, according to the same review 1.
- Treatment generally consists of activity modification, relative rest from aggravating activities for 4-6 weeks, ice application for 15-20 minutes several times daily, over-the-counter pain medications like ibuprofen or acetaminophen, and physical therapy focusing on quadriceps and hamstring stretching and strengthening.
- A knee brace or patellar strap may provide symptomatic relief during recovery.
- Referral to an orthopedic specialist would be appropriate if symptoms persist beyond 3-6 months of conservative treatment, but rheumatology consultation is unnecessary as this is a mechanical rather than inflammatory or autoimmune condition, as supported by various case reports and studies 2, 3, 4.
Management Approach
The management approach for Sinding-Larsen and Johansson syndrome focuses on conservative treatment, aiming to reduce symptoms and promote healing. This approach is supported by recent studies, including a scoping review that highlights the effectiveness of conservative treatments 1. In some cases, arthroscopic treatment may be considered for professional athletes with persistent symptoms, as reported in a case study 3. However, for most patients, a conservative management approach is recommended, with referral to an orthopedic specialist if necessary.