Posterior hip dislocation
Painful right hip following a car accident. Otherwise fit, active athlete.
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The femoral head is displaced upwards and posterior to the acetabulum, indicative of a posterior hip dislocation. A little bony fragment is noted, projected over the femoral neck representing the posterior rim of the acetabulum.
Otherwise, a bilateral apophysitis of the iliac crest is seen.
Posterior hip dislocation more common than anterior hip dislocations, and are generally the result of violent trauma.
After reduction of the dislocation, it is important to perform a Judet view and CT, to confirm the total joint reduction. It is important to search for intra-articular bone fragments, acetabular rim, and columns fractures.
Iliac crest apophysitis is relatively uncommon. It is due to the repetitive action of the abdominal muscles. It is often seen in runners, soccer players, dancers and gymnasts; but may occur in any athlete. It is generally seen between the ages of 9 and 16 years. But can occur as late as 20 years in boys and 18 years in girls 1.
- 1. Risser JC. The iliac apophysis: an invaluable sign in the management of scoliosis. Clinical Orthop. 1958;11:111–113.
- 2. Richardson P, Young JW, Porter D. CT detection of cortical fracture of the femoral head associated with posterior hip dislocation. AJR Am J Roentgenol. 1990;155 (1): 93-4. doi:10.2214/ajr.155.1.2112874 - Pubmed citation