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Thread: Finding-Larsen-Johansson Disease Pictures - Pediatric cases

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    Default Finding-Larsen-Johansson Disease Pictures - Pediatric cases

    Who Gets It?
    SLJ mostly happens to people between the ages of 10 and 15 because that's when most of us have growth spurts. SLJ is more common in teens who play sports that require a lot of running or jumping, because these activities put excess or repetitive strain on the knee.

    How Is SLJ Diagnosed?
    If you see a doctor for knee problems, he or she will ask questions about how much pain you're having and if you do any sports or other activities. Your doctor will probably also look through your medical records to see if you've had a recent growth spurt. The doctor will also examine your knee for swelling and tenderness.

    What Causes SLJ Syndrome?
    The large muscle group at the front of the upper leg is called the quadriceps. Every time you straighten your leg, your quadriceps pulls on your patellar tendon to bring your lower leg forward. This puts stress on the growth plate at the bottom of your kneecap.

    When we go through a period of rapid growth, our bones and muscles don't always grow at the same rate. As the bones grow longer, muscles and tendons can become stretched and tight. This adds to the strain on the patellar tendon and on the growth plate it is attached to. Repetitive or excess stress in this area can cause the growth plate to become irritated and painful.

    How Can You Prevent SLJ Syndrome?
    The most important thing you can do to prevent getting SLJ is to stop doing an activity that causes pain in your knee at the first signs of irritation. Then, try to limit your activity until the pain goes away.

    It's vital to warm up well and stretch before exercising or playing sports. Take a light jog around the track or field for a few minutes to get your blood circulating, then do some dynamic stretching.

    If your quadriceps muscles are tight, you may want to do some static stretches for this area ― ask your athletic trainer or a sports medicine expert what's best for you. Doing a few static stretches when you're finished with an activity also helps prevent tight muscles. Hold each stretch for at least 30 seconds.

    How Should You Treat SLJ Syndrome?
    The first ― and most important ― thing to do is to stop any activity that causes irritation in your knee. Don't resume your activities until you can run, jump, and stretch without pain or a doctor has cleared you to play again.

    SLJ can be tricky because it might not completely resolve until your bones have fully matured and your growth plates are completely closed. In the meantime, knee pain may come and go during activity.

    Epidemiology
    Unlike "jumper's knee" which is seen at any age, Sinding-Larsen-Johansson disease is seen in active adolescents, typically between 10-14 years of age 1. Children with cerebral palsy are also prone to SLJ 4.
    Finding-Larsen-Johansson Disease Pictures Pediatric cases attachment.php?s=ff184fc2aa64fad6116d748cdca19967&attachmentid=1760&d=1441142634

    Clinical presentation
    Presentation is with point tenderness at the inferior pole of the patella associated with focal swelling.

    Conventional radiograph
    Early findings are subtle or absent. Thickening of the proximal patellar tendon may be seen with possible stranding of the adjacent portions of Hoffa's fat pad. Dystrophic calcification/ossification may eventually occur.

    What is the Symptom Progression?
    While a mild case of Sinding Larsen Johansson syndrome can resolve within a few weeks, severe cases must be professionally managed to avoid growth plate damage. The pain and swelling symptoms can potentially last for years. Longstanding Sinding-Larsen-Johansson syndrome can result in an avulsion fracture of the patella tendon, which can severely affect your ability to walk or run

    How is Sinding Larsen Johansson Syndrome Diagnosed?
    Sinding Larsen Johansson Syndrome is normally diagnosed clinically by your physiotherapist or doctor. Knee X-ray can show calcification or ossification at the junction between the patella and the patella ligament. MRI scan will exclude most other musculoskeletal injuries.

    Treatment for Sinding Larsen Johansson Syndrome
    Physiotherapy assessment and treatment is a proven benefit for Sinding-Larsen-Johansson syndrome sufferers. Left untreated most patients will fully resolve their symptoms within 3 to 18 months (Duri et al 2002). With the good management, most athletes will be able to return to their sport within 6 to 14 weeks (Iwamoto et al 2009).

    Strengthening
    Your muscle control around the knee will usually need to be addressed to control or maintain your symptoms during the active phase of Sinding-Larsen-Johansson syndrome. Your physiotherapist will commonly prescribe or modify exercises for your quadriceps, hamstrings, calves, foot arch and gluteal (buttock) muscles. (Franchesci et al 2007)

    References:
    Sinding Larsen Johansson Syndrome
    Sinding-Larsen-Johansson Syndrome
    Sinding-Larsen-Johansson disease | Radiology Reference Article | Radiopaedia.org











    Last edited by Medical Photos; 09-01-2015 at 09:23 PM.

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