Apophyseal avulsion fractures of the pelvis and hip

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Apophyseal avulsion fractures of the pelvis and hip are relatively common among physically active adolescents and young adults.

Epidemiology

Pelvic and hip apophyseal injuries typically occur in the 14 to 25 year age range.

Mechanism

Kicking sports, such as soccer, and gymnastics are frequently implicated.

Pathology

Sudden forceful muscular contraction causes avulsion of the apophysis to which the tendon attaches.

Sites of avulsion

iliac crest: anterior abdominal wall muscles
anterior superior iliac spine: tensor fascia lata and sartorius
anterior inferior iliac spine: straight head of rectus femoris
greater trochanter: gluteus medius and gluteus minimus
lesser trochanter: iliopsoas muscle
ischial tuberosity: hamstring muscles
body and inferior ramus of pubis: thigh adductors and gracilis

Image 5 MRI (PD fat sat) ( create )

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