Traction Apophysitis
A 12-year-old boy who plays representative basketball presents with a 3-month history of anterior knee pain. The pain is localised to the inferior pole of the patella and worsens with running, jumping, and stair climbing. He has been playing through the pain but it is affecting his performance. On examination, there is exquisite point tenderness at the inferior pole of the patella, with mild swelling. Pain is reproduced with resisted knee extension. Lateral knee radiograph shows fragmentation and irregularity at the inferior patellar pole with adjacent soft tissue swelling. Regarding this condition:
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This is Sinding-Larsen-Johansson (SLJ) syndrome, a traction apophysitis affecting the inferior pole ...
The pathophysiology involves repetitive traction forces from the patellar tendon on the immature sec...
Surgical excision of the fragmented bone is the first-line treatment for SLJ syndrome because the bo...
Conservative management is the mainstay of treatment and includes relative rest from aggravating act...
SLJ syndrome must be distinguished from other causes of anterior knee pain including patellar tendin...
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