Learning objectives
1-To recognise the characteristic imaging findings in common avulsion injuries of the pelvis.
2-Understanding the musculotendinous anatomy which aid in accurate diagnosis of these injuries.
3-Demonstration of appropriate imaging techniques.
Background
Avulsion injuries are common in young adults,
especially sportsmen and athletes.
Avulsion injuries commonly occur at seven sites in the pelvis which include:
1: Ischial tuberosity: Insertion of Hamstring tendons
2: Anterior superior iliac spine:Sartorius and tensor fascia lata
3: Anterior inferior iliac spine: Rectus femoris
4: Superior and inferior pubic rami: Adductor group of muscles
5: Lesser Trochanter: Iliopsoas muscle
6: Greater Trochanter: Glutei ,
Obturater internus,
Gemellus,
Piriformis.
7: Iliac crest: Abdominal musculature.
These are often associated with strain or tear of the...
Imaging findings OR Procedure Details
Pelvic radiographs may demonstrate an avulsed bony fragment in a setting of acute or chronic injury.
CT scan is excellent for demonstrationof tiny displaced bony fragments and associated muscle injury with or without hematoma.
Ultrasound,
although excellent in diagnosing myotendinous strain,
partial or complete tear,
has its limitations.
Its operator dependence and unclear anatomical depiction to surgeons,
makes it being utilized as a screening modality.
Magnetic resonance imaging is often used for detailed evaluation of the concerned tendon and muscles.
Its role has been well...
Conclusion
The avulsion fractures of pelvis are common especially in young athletes.
Radiographs and CT scan reveal avulsed pieces of bone.
MRI is helpful for detailed evaluation of the muscles and tendons.
These fractures are increasingly recognised and are assessed in a better and detailed manner with these imaging techniques.
Early detection of these injuries is important for appropriate and timely treatment.
References
Rossi F,
Dragoni S.
Acute avulsion fractures of the pelvis in adolescent competitive athletes: prevalence,
location and sports distribution of 203 cases collected.
Skeletal Radiol. 2001; 30(3):127-131.
Metzmaker JN,
Pappas AM.
Avulsion fractures of the pelvis.Am J Sports Med. 1985; 13(5):349-358.
Martin TA,
Pipkin G.
Treatment of avulsion of the ischial tuberosity.
Clin Orthop Relat Res.
1957; (10):108-18.
Apophyseal Avulsion Fractures of the Hip and Pelvis ,Bart I.
McKinney,
MD; Cory Nelson,
MD; Wesley Carrion,
MD.Orthopedics: January 2009 - Volume 32 · Issue 1.
Ingrid...
Personal Information
1-Syed Intakhab Alam.
[email protected]
Dept of Radiology ,
Hamad General Hospital,
Doha,
Qatar.
2-Devendra Kumar
[email protected]
Department of Radiology,
Al Wakra Hospital,
Doha,
Qatar
3- Maneesh Khanna
[email protected]
Dept of Radiology ,
Hamad General Hospital,
Doha,
Qatar.
4- Habeeba Hena.
[email protected]
Dept of Radiology,
Al-Wakra Hospital,
Doha,
Qatar.
5- Mahmoud Al Heidous
Department of Radiology,
Al Wakra Hospital,
Doha,
Qatar
[email protected]
6-Omar Moawayh Osman
[email protected]
Dept of Radiology ,
Hamad General Hospital,
Doha,
Qatar.
7-Ahmed Mohamed Refaat.
[email protected]
Dept of radiology ,
Hamad General hospital,Doha,...