Sinding-Larsen-Johansson disease

Case contributed by Domenico Nicoletti


Pain in anterior knee over 6 months time without any history of direct trauma. Pain is worse during sporting activities.

Patient Data

Age: 15 years
Gender: Male

MRI left Knee


Thickening of patellar tendon at its proximal insertion and intense edema of Hoffa’s fat pad with marrow edema over inferior pole of the patella. The T1 and STIR axial sequences show a patellar sleeve fracture with a traumatic separation of the distal articular cartilage with a bony fragment of the patellar inferior pole, anterior and medially. The menisci, collateral ligaments and cruciate ligaments are normal. There is no joint effusion.

Case Discussion

Sinding-Larsen-Johansson disease is an osteochondrosis at the proximal attachment of patellar tendon, which is common in adolescents. This may be caused by repetitive microtrauma to the tendon at the insertion to lower pole of patella with traction tendinitis.


Radiographer: TSRM Fabio Imola

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