Avulsion Fracture of Anterior Inferior Iliac Spine in a Skeletally Mature Man; Mimicking Pathologic Bone Lesion

Abstract

Avulsion fractures of the pelvis occur in both the

Avulsion fracture of anterior inferior iliac spine complicated by hypertrophic malunion causing femoroacetabular impingement: Case report

“…The mechanism of anterior inferior iliac spine avulsion fracture is due to the pull of the straight head of the rectus femoris muscle [1,3] which usually occurs with hip joint extended while the knee joint in a flexed position, and it is usually seen after sports that involve mostly forceful kicking or running like soccer, rugby and tennis players [5,6] . A high index of suspicion is needed for the diagnosis of anterior inferior iliac spine fractures and generally is established with proper clinical history, physical examination and radiographs of the pelvis [1,2,12] .…”

“…The anteroposterior and oblique radiographs of the pelvis should be interpreted with caution and the affected side should always be compared with the other side since the avulsed fragment is generally minimally displaced [3,12] . To confirm the diagnosis, CT scan is indicated [14] .…”

“…However, femoroacetabular impingement due to hypertrophic malunion of avulsed fracture of anterior, inferior iliac spine has rarely been reported [9–12] .…”

Anterior Inferior Iliac Spine Avulsion Fracture

“…These usually occur in adolescents when the ratio of muscular strength to physeal strength is greatest. 3 Nonoperative treatment is usually recommended for avulsions from the AIIS. Avulsion fractures of the AIIS are often mistaken for muscle or tendon injuries.…”

“…These must also be differentiated from os acetabuli (an accessory ossicle at the superior rim of the acetabulum), traumatic myositis ossificans of the rectus femoris, and bone tumors. 3 Early diagnosis and proper management of AIIS fractures are imperative to prevent them from becoming chronic and potentially career limiting. Physicians must cautiously perform detailed physical examinations and correlate the clinical condition and radiologic findings to avoid misdiagnosis.…”