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Ischial tuberosity avulsion injury

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

? Hamstring injury

Patient Data

Age: 13 years
Gender: Male

Subtle decreased thickness of the right ischial tuberosity compared to the left without any obvious avulsed bone. 

There is apophyseal avulsion from the right ischial tuberosity. A large semilunar fragment of cartilage measuring 4cm in size has been detached from the body of the ischial tuberosity. The apophyseal fragment is distracted by 1.4cm and there is a fluid field cavity within the spaces. The hamstring origin remains attached to the apophysis. Blood fluid products track around the obturator internus, obturator externus and quadratus femoris muscles and encase the sciatic nerve. 

Case Discussion

Acute complete avulsion of the right ischial tuberosity apophysis. The apophysis is largely cartilaginous in this patient which makes it very difficult to detect the injury on x-ray. 

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