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Case of the Week 539


What is the most likely diagnosis?

  • 15 year-old sprinter with hip pain



Frontal Radiograph of the Left Hip

  1. Fracture of the Greater Trochanter
  2. Separation of the SI Joint
  3. Separation of the Symphysis Pubis
  4. Slipped Capital Femoral Epiphysis
  5. Avulsion of Ant. Inferior Iliac Spine

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Answer:

 

5. Avulsion of Ant. Inferior Iliac Spine

 

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Avulsion of Anterior Inferior Iliac Spine

General Considerations

  • Avulsion fractures result when the fracture fragment is pulled from its parent bone by forceful contraction of a tendon or ligament
  • Avulsion fractures are most common in younger individuals engaging in athletic endeavors
  • In the pelvis, the newly formed secondary centers of ossification, the apophyses, are the most likely portions of the bone to avulse
  • Since the apophyses tend to form at the time of puberty, most of these pelvic avulsions occur at the time of puberty
  • In general, they are uncommon injuries, seen almost exclusively in adolescent athletes with a 2:1 male to female preponderance

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is an award-winning educational website aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of cases, quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, GU cardiac, bone and neuroradiology.