Anterior superior iliac spine (ASIS) avulsion injury

Case contributed by Ashesh Ishwarlal Ranchod


Blunt trauma during sporting activity, patient fell awkwardly.

Patient Data

Age: 15 years
Gender: Male

Plain films confirm an acute right anterior superior iliac spine avulsion fracture injury. This is consistent with a sartorius and/ or tensor fascia lata avulsion injury. There is skeletal maturity.

There is incidental asphericity of the femoral head with a cam morphological appearance of the femoral head-neck junction likely related to high-impact sporting activity and overuse during adolescence.

There is a suspected lumbar-sacral transitional vertebra (LSTV), with a right-sided giant transverse process and pseudoarthrosis (Castellvi 2a).

Case Discussion

Findings consistent with known background high impact sporting activity (football) and fracture avulsion injury of the anterior superior iliac spine in this adolescent individual. Conservative management was recommended.

There is probable early skeletal maturity (Risser stage 5) at 15 years of age.

There is a bilateral, cam type of femoral head-neck junction morphology in this highly active individual and this may predispose to a clinical femoral acetabular impingement syndrome in the future.

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