Osgood-Schlatter or Sinding-Larsen-Johansson: where exactly is my child's knee pain?

The short verdict

These are two versions of the same story at different ends of the patellar tendon. During growth spurts, the tendon pulls hard on areas of bone that are still maturing. If the sore spot is the bony bump at the top of the shin, it is Osgood-Schlatter. If it is the lower tip of the kneecap, it is Sinding-Larsen-Johansson. Neither is dangerous, and children can usually stay active with sensible adjustments.

How they compare

• Location: Osgood-Schlatter is at the bump below the knee on the shin; Sinding-Larsen-Johansson is at the lower edge of the kneecap
• Age: Sinding-Larsen-Johansson tends to appear a little earlier, often around 10 to 13; Osgood-Schlatter commonly around 10 to 15
• Lump: Osgood-Schlatter often leaves a visible, tender bump; Sinding-Larsen-Johansson usually does not
• Triggers: both are worse with running, jumping, kneeling and stairs
• X-ray: may show changes at the shin bump or the kneecap tip, and helps rule out other causes
• Outlook: both usually settle over months to a couple of years as growth finishes; surgery is rarely needed

Who each tends to affect

Both tend to affect children and young teenagers in growth spurts who play football, basketball, volleyball, gymnastics or athletics, including those in Qatar's school and academy sport programmes. Boys were historically affected more often, but girls in jumping sports are commonly affected too. Older teenagers with similar pain at the tip of the kneecap are more likely to have jumper's knee, a related tendon problem.

When to see a knee surgeon in Doha

See a doctor if pain is severe, present at rest or at night, if your child limps, if the knee is swollen or locks, or if pain follows a specific injury. Pain in only one knee with a limp should also prompt a hip check. Dr. Gelber at Aman Hospital will examine your child, confirm the diagnosis, and give a practical plan for sport and school.