Apophyseal avulsion injury of the anterior superior iliac spine (ASIS)
Diagnosis certain
Presentation
Marked left groin pain after vigorous gymnastics training with limited left hip movement. No direct trauma to the pelvis.
Patient Data
Age: 15 years
Gender: Male
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/116753/annotated_viewer_json?iframe=true\u0026lang=us"}
There is a small separable bony chip along the ASIS.
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/116754/annotated_viewer_json?iframe=true\u0026lang=us"}
Left anterior superior iliac spine avulsion fracture is noted.
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/116756/annotated_viewer_json?iframe=true\u0026lang=us"}
Left anterior iliac bone /anterior superior iliac spine marrow edema with adjacent small localized fluid signal and mild muscular edema of bright STIR and T2 signals.
Case Discussion
The typical age and the classic history of pain after gymnastics training favor an apophyseal avulsion fracture of the anterior superior iliac spine.
The ASIS is the site of attachment for sartorius and tensor fascia lata muscles and is most commonly avulsed in adolescent athletes.