Pubic ramus stress fracture

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Elite distance athlete. Deep left gluteal pain.

Patient Data

Age: 25
Gender: Female
mri

Near-complete subacute stress fracture of the left inferior pubic ramus.  Ill defined area of marrow edema in the anterior aspect of the acetabulum may represent another area of bone stress without an associated fracture. Narrowing of the ischiofemoral distance and mild edema within quadratus femoris indicating mild ischiofemoral impingement.  Mild gluteal bursitis and anterior facet gluteus medius tendon partial tear. Small amount of edema at gluteus minimus attachment to the iliac crest. Moderate hip joint effusion and evidence of old healed left femoral neck stress fracture.  

Case Discussion

Inferior pubic ramus stress fracture in an elite athlete. Additional findings include low grade ischiofemoral impingement, small partial tear of the gluteus medius tendon insertion and old healed femoral neck stress fracture.  

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