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In the child, overuse injury of the proximal patellar tendon (Sinding-Larsen–Johansson syndrome) is a rare self-limiting condition.
SLJ is an enchondral ossification disorder of the inferior pole of the patella, and is part of the osteochondrosis spectrum of diseases.
It is a type of osteochondrosis at the proximal attachment of patellar ligament.
A traction tendonitis, Sinding-Larsen-Johansson syndrome results in calcification or ossification of the patellar tendon and can often be demonstrated at plain radiography.
A traction tendonitis, Sinding-Larsen-Johansson syndrome results in calcification or ossification of the patellar tendon and can often be demonstrated at plain radiography.
The chronic traction at the inferior pole of the patella results in the formation of heterotopic ossification, giving a typical imaging appearance.
Osgood Schlatter disease is a similar overuse traction injury at the insertion of the patellar tendon into the tibial tubercle.
Patellar sleeve fractures are unique to the pediatric population and are most commonly seen in the 8- to 12-year-old age group.
Avulsion of the inferior pole of the patella is a fracture seen predominantly in the immature skeleton and is often termed a ”sleeve fracture,” because a sleeve of unossified cartilage and bone is stripped off the lower pole of the patella.
References
Schmidt-Hebbel A, Eggers F, Schütte V, Achtnich A, Imhoff AB. Patellar sleeve avulsion fracture in a patient with Sinding-Larsen-Johansson syndrome: a case report.
BMC Musculoskelet Disord. 2020 Apr 23;21(1):267.
doi: 10.1186/s12891-020-03297-z. PMID: 32326930; PMCID: PMC7181494.
Xie L, Xu H, Zhang L, Xu R, Guo Y. Sleeve fracture of the adult patella: Case report and review of the literature.
Medicine (Baltimore). 2017 Aug;96(32):e7096.
doi: 10.1097/MD.0000000000007096. PMID: 28796028; PMCID: PMC5556194.
Ostlere S. The extensor mechanism of the knee.
Radiol Clin North Am. 2013 May;51(3):393-411.
doi: 10.1016/j.rcl.2012.11.006. Epub 2013 Jan 17. PMID: 23622091.
Dupuis CS, Westra SJ, Makris J, Wallace EC. Injuries and conditions of the extensor mechanism of the pediatric knee.
Radiographics. 2009 May-Jun;29(3):877-86.
doi: 10.1148/rg.293085163. PMID: 19448122.
Hunt DM, Somashekar N. A review of sleeve fractures of the patella in children.
Knee. 2005 Jan;12(1):3-7.
doi: 10.1016/j.knee.2004.08.002. PMID: 15664870.
Case 726
Patella sleeve fracture
Published on 13.03.2001
DOI: 10.1594/EURORAD/CASE.726
ISSN: 1563-4086
Case 6377
Sinding-Larsen and Johansson Syndrome: MRI findings
Published on 15.05.2008
DOI: 10.1594/EURORAD/CASE.6377
ISSN: 1563-4086
https://radiopaedia.org/cases/patellar-sleeve-avulsion-illustrations?lang=us
MRI Web Clinic — October 2009
Developmental Variants
Ingrid Kjellin, M.D.
https://radsource.us/developmental-variants
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