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Case 29-18 yo/M patient with left hip discomfort

Patient presents with left groin discomfort.

18 yo/M – the left-handed baseball player with left hip discomfort of 2 weeks duration.  Worsening of signs & symptoms. No prior corticosteroid/opioid regimen or carcinoma is reported.

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Left hip pain_ AP PELVIS VIEWS

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Close up-left hip- showing minimal displacement with cortical disruption of inferior pubic ramus.

The coned  view  above optimally shows two transversely oriented radiolucencies in addition to the radiographic findings described above. 


  • avulsion of the ischial tuberosity (AFIT)- is a rare adolescent sports injury
  • no standard treatment protocol exists.
  • if the fracture fragment shows >1.5 cm. displacement, surgery may indicated.



Between 13 – 15 years of age, the ossification center of the ischial tuberosity begins. This structure is 2-5 x weaker than the surrounding tendons & ligaments. A sudden exertion can cause avulsion of the epiphysis from the parent inferior ramus.  The biceps semimembranosus tendon has a lateral origin on the ischial tuberosity.


Plain film examination if the initial imaging modality. Occult fractures can be detected with MRI scanning because it demonstrates the presence/extent of edema on fluid-sensitive images.


Case compliments of Dr. A. Calderone DC Stuart, Florida


  1. 2018  Avulsion Fractures of Ischial Tuberosity: Progression of Injury, Mechanism, Clinical Manifestations, Diagnosis & Differential Diagnosis & Treatment. DOI 10.12659/MSM.913799. This study based on literature review.
  2.  2016 Ischial Tuberosity Avulsion Fracture After Short Period of Repetetive Training CASE REPORT Hip & Pelvis 28 (3):187-190 2016

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