- Avulsion fracture of the ischial tuberosity
- Hamstring syndrome
- Proximal hamstring tendinopathy
- Pubic apophysitis
This patient has an avulsion fracture of the ischial tuberosity, seen as displacement of the apophysis.
Learnings/What to Look for
- This injury is seen most commonly seen in young athletes, especially soccer players. It results from sudden, forceful contraction of the hamstrings
- Patients in puberty and late adolescence are at greatest risk, as this is a time when the secondary ossification centre or apophysis is weakest in the chain of muscle–tendon–bone
Pearls for Urgent Care Management and Considerations for Transfer
- Radiograph of the pelvis should be performed in adolescent patients with a history of proximal hamstring injury and current ischial tenderness
- Displaced avulsion fragments or chronic nonunion fragments may require surgical repair.
Acknowledgment: Image courtesy of Teleradiology Specialists.