OSGOOD-SCHLATTER SYNDROME

Children with Osgod-Schlatter syndrome classically complain of pain or discomfort located at the distal attachment site of their patella tendon (kneecap tendon) onto the tibia. Initially the discomfort may only be apparent after sporting activities whilst at later stages children often describe a continuous ache. The attachment site may be swollen and tender, and children usually try and avoid kneeling. The diagnosis is established through clinical examination and lateral radiographs. MRI scan is particularly useful in the beginning when radiographs are often unequivocal. The treatment is based on activity adjustment and reduction focussing in particular on avoidance of patello-femoral loading activities. Initially ice application and nonsteroidal anti-inflammatory drugs may be of benefit. Plaster immobilisation is reserved for more severe cases. If pain and discomfort prevails until adulthood, excision of ossicles may be indicated.

SINDING-LARSON-JOHANSSON SYNDROME

If the child complains of pain closer to the inferior patella pole (bottom of the kneecap) the possibility of patella osteochondrosis or Sinding-Larson-Johansson Syndrome (SLJ) should be investigated. SLJ is in essence a similar problem as Osgood-Schlatter Syndrome albeit in a different location. Subsequently the treatment recommendations are similar to those given for Osgood-Schlatter.

Like Osgood-Schlatter disease, Sinding-Larsen-Johansson Syndrome is classified as a traction apohysitis. It is a self-limiting disorder, which usually resolves when patients reach maturity. Activity adjustment and symptomatic measures (ice, ultrasound, anti-inflammatory topics etc.) are generally recommended. Only in very few cases is operative intervention required.