Ultrasonic diagnosis of Osgood-Schlatter and Sinding-Larsen-Johansson diseases of the knee

Flaviis, Luca De; Nessi, R; Scaglione, P.; Balconi, Giuseppe; Albisetti, W.; Derchi, Lorenzo E.

doi:10.1007/bf00360969

Cited by 97 publications

(58 citation statements)

References 21 publications

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“…US findings are the same as those in OSD: cartilage swelling, patellar tendon swelling at its proximal insertion and patellar fragmentation at its distal pole [6] (Fig. 3).…”

Section: Sinding-larsenejohansson Syndromesupporting

confidence: 64%

Overload syndromes of the knee in adolescents: Sonographic findings

Draghi

Danesino

Coscia

et al. 2008

Journal of Ultrasound

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KEYWORDSSonography; Knee; Overload syndromes.Abstract Overload syndromes are caused by repetitive microtrauma, and the knee joint is most frequently affected in adolescents. The reason for this is that the knee joint is engaged in almost all sports activities. Pathologies related to the anterior aspect of the knee are: femoropatellar pain, jumper's knee syndromes, OsgoodeSchlatter disease, Sinding-Larsene Johansson syndrome and patellar stress fractures; to the medial aspect: semimembranous tendon enthesopathy and pes anserinus bursitis; to the lateral aspect: iliotibial band syndrome (runner's knee), popliteus and femoral biceps tendon enthesopathy; to the posterior aspect: fabella syndrome and medial gastrocnemius muscle tendon enthesopathy. Sonography plays a central role in the diagnosis and can also evaluate the evolution of diseases. This method is well accepted by the patients and by their parents, it does not involve exposure to X-rays and it is inexpensive. US imaging should, therefore, be considered a first-line imaging diagnostic technique in functional overuse syndromes of the knee.Sommario Le sindromi da sovraccarico riconoscono come causa principale i microtraumi ripetitivi e il ginocchio è l'articolazione interessata più frequentemente negli adolescenti. La ragione è legata al fatto che il ginocchio è particolarmente sollecitato in tutte le attività fisiche, sia della vita quotidiana sia nelle attività agonistiche. Possono essere interessate varie strutture con conseguenti e diverse patologie, in particolare nel comparto anteriore si realizzano lesioni dell'articolazione femoro-rotulea, del tendine rotuleo (jumper's knee), le sindromi di Osgood-Schlatter e di Sinding-Larsen-Johansson, fratture da stress della rotula; nel comparto mediale la sindrome della plica sinoviale, tendinopatie del tendine del semimembranoso, borsiti della borsa della zampa d'oca; nel comparto laterale la sindrome da frizione della bendelletta ileo-tibiale (runner's knee), tendinopatie del tendine popliteo e del bicipite; nel comparto posteriore patologie legate alla fabella e al tendine del gemello mediale. L'ecografia è in grado porre diagnosi e di valutare il decorso della malattia nella grande maggioranza di queste lesioni, è ben accetta ai pazienti e ai genitori per l'assenza di controindicazioni e di radiazioni ionizzanti, ha costi contenuti ed è pertanto l'esame di scelta nelle sindromi da sovraccarico del ginocchio nell'adolescente. Richiede esperienza e l'integrazione di radiologia tradizionale, TC e RM in alcuni casi quali l'inquadramento delle malformazioni e il disallineamento degli arti inferiori. ª

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“…US findings are the same as those in OSD: cartilage swelling, patellar tendon swelling at its proximal insertion and patellar fragmentation at its distal pole [6] (Fig. 3).…”

Section: Sinding-larsenejohansson Syndromesupporting

confidence: 64%

Overload syndromes of the knee in adolescents: Sonographic findings

Draghi

Danesino

Coscia

et al. 2008

Journal of Ultrasound

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“…Characteristic radiographic findings of apophysitis include fragmentation, sclerosis, and irregularity of the apophysis. 9,14 Conventional radiographs are usually sufficient for diagnosis, but magnetic resonance imaging (MRI) and radionuclide bone scan will be definitive if plain films are inconclusive or unavailable. T1-and T2-weighted MR sequences will demonstrate multiple foci of hypointensity and a change in the bony contour of the acromial apophysis when compared with the contralateral normal apophysis.…”

Section: Discussionmentioning

confidence: 99%

Acromial apophysitis in a 13-year-old adolescent boy: a common condition in an uncommon location

Quinlan

Bogar

2012

Journal of Chiropractic Medicine

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Objective: Traction apophysitis is a common condition in physically active and skeletally immature adolescents. This case study describes the clinical presentation and plain film imaging of traction apophysitis of the acromion process of the scapula. Clinical Features: A physically active 13-year-old adolescent boy presented to a chiropractic physician with an acute onset of moderate shoulder pain. Plain film radiographs of the shoulder were performed that revealed fragmentation, sclerosis, and irregularity of the left acromial apophysis. Intervention and Outcome: The patient was treated with conservative therapy for 10 weeks, with complete resolution of symptoms. Follow-up radiographs 9 weeks later revealed no radiographic change in the appearance of the apophysis; however, clinical symptoms were absent. The apophyseal growth cartilage is the most vulnerable site in the muscle-tendon unit in the skeletally immature patient and is more susceptible to very small avulsion fractures. Repetitive microtrauma following chronic overuse at a tendon insertion site in a skeletally immature patient may result in traction apophysitis. Conclusions: Acromial apophysitis should be included in the differential diagnosis when presented with a young active patient with shoulder pain. Early treatment with restriction of activities is important in the prevention of permanent injury to the acromial cartilaginous growth plate. This case demonstrates that a prompt diagnosis can be made with a careful history, physical examination, and conventional imaging.

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“…Sinding-Larsen-Johansson disease is clinically characterized by pain localized at the distal pole of the patella, increasing during flexion combined with loading of the knee joint. Other clinical features include swelling of the infrapatellar soft tissues and functional limitations (3,22). The disease is caused by repetitive microtraumas and excessive prolonged stress occurring on a specific skeletal region that is both mechanically and biologically weak, when the stress exceeds the intrinsic resistance.…”

Section: Sinding-larsen-johansson Diseasementioning

confidence: 99%

“…In Sinding-Larsen-Johansson disease, ultrasonography shows cartilage and patellar tendon swelling at its proximal insertion and fragmentation at the patellar distal pole (22,23) (Fig. 4).…”

Section: Sinding-larsen-johansson Diseasementioning

confidence: 99%

State-of-the-art ultrasonographic findings in lower extremity sports injuries

et al. 2015

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: Athletes sometimes experience overuse injuries. To diagnose these injuries, ultrasonography is often more useful than plain radiography, computed tomography (CT), or magnetic resonance imaging (MRI). Ultrasonography can show both bone and soft tissue from various angles as needed, providing great detail in many cases. In conditions such as osteochondrosis or enthesopathies such as Osgood-Schlatter disease, SindingLarsen-Johansson disease, bipartite patella, osteochondritis dissecans of the knee, painful accessory navicular, and jumper's knee, ultrasonography can reveal certain types of bony irregularities or neovascularization of the surrounding tissue. In patients of enthesopathy, ultrasonography can show the degenerative changes at the insertion of the tendon. Given its usefulness in treatment, ultrasonography is expected to become essential in the management of overuse injuries affecting the lower limb in athletes.

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Ultrasonic diagnosis of Osgood-Schlatter and Sinding-Larsen-Johansson diseases of the knee

Cited by 97 publications

References 21 publications

Overload syndromes of the knee in adolescents: Sonographic findings

Overload syndromes of the knee in adolescents: Sonographic findings

Acromial apophysitis in a 13-year-old adolescent boy: a common condition in an uncommon location

State-of-the-art ultrasonographic findings in lower extremity sports injuries

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