Musculoskeletal Sonography Facilitates the Diagnosis of Adolescent Anterior Superior Iliac Spine Avulsion Fracture

Abstract

KEY WORDSanterior superior iliac spine, avulsion fracture, sonography Anterior superior iliac spine (ASIS) avulsion fractures are not common. We describe a 15-yearold boy who suffered from sudden onset of pain on the left side of his groin when running a race, accompanied by weakness in raising his left leg. Physical examination revealed local tenderness over left ASIS area, initial pelvic radiograph showed no abnormalities, but kidney-ureter-bladder radiograph revealed a small indistinct radiopaque shadow lateral to iliac bone. Then, musculoskeletal sonography disclosed the displacement of the apophysis from the left ASIS, and avulsion fracture was impressed. Pelvic computed tomography confirmed the diagnosis. The patient gradually recovered after conservative treatment. Groin pain in athletes is a dilemma in diagnosis, and careful correlation of the clinical condition and radiological findings is essential to avoid misdiagnosis. Musculoskeletal ultrasound is a useful tool for quick screening and to facilitate diagnosis. ª

Avulsion Fracture of the Anterior Superior Iliac Spine in a Young Athlete Detected by Point-Of-Care Ultrasound

“…Reports of ultrasound use in diagnosing PAFs are scarce. A previous case report from a rehabilitation department showed the utility of ultrasound for detecting an ASIS avulsion fracture in adolescent male although the technique was performed after a pelvic X-ray finding led to suspicion of a fracture [6]. A previous case-series study demonstrated that ultrasound performed by a radiologist was useful in detecting ASIS and AIIS avulsion fractures [7].…”