Bilateral synchronous Sinding-Larsen-Johansson and Sever Disease in a 10-year-old boy: A case report

Abstract

Introduction: Growing pains are frequent in children, recognizing several causes and sometimes requiring management. Among these conditions, apophysitis and osteochondrosis may interest children who practice sport activities. In this case report, we found an association between a form of osteochondrosis, the Sinding-Larsen-Johansson Disease and a type of apophysitis, the Sever Disease in the same patient. Case Description: A 10-year-old boy presented with a 3-month bilateral non-specific anteroinferior knees and posterior heels pain history with worsening in the last month particularly after athletic activities. Patient presented mild swelling of the bilateral heel face, antalgic gait, bilateral painful palpation over the patella inferior pole and bilateral heel pain. Based on the clinical and instrumental evaluation, bilateral Sinding-Larsen-Johansson Disease and Sever Disease was diagnosed. Temporary abstention from sport and conservative approach led to complete symptoms’ regression after three months and to the gradual return to sport. Discussion and Conclusion: This is a singular case of a combination of Sinding-Larsen-Johansson Disease and the Sever Disease in both lower limbs and with painful symptoms present at the same time. The correct dosage of physical activity and training intensity, education to healthy lifestyle habits, can represent preventive strategies to avoid overuse of childhood diseases.

Keywords

• Sever disease
• Sinding-Larsen-Johansson
• Paediatric orthopaedic
• Paediatric rehabilitation
• Growing pain