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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Synonyms
- Acute injury: Avulsion fracture
- Chronic injury: Apophysitis, physeal stress fracture, osteochondrosis, various eponyms specific to site
Definitions
- Apophysis: Nonarticular secondary center of ossification that serves as attachment site for muscle or tendon
- Contributes to bony shape but not length
- Considered epiphyseal equivalent
- Acute injury: Avulsion fracture of osseous &/or cartilaginous apophysis through subjacent physis
- Chronic injury: Repetitive submaximal tensile forces (avulsive microtrauma) exceed rate of repair, leading to local growth plate disturbance (± symptoms)
- Apophysis: Nonarticular secondary center of ossification that serves as attachment site for muscle or tendon
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
- Franz P et al: Tibial tubercle avulsion fractures in children. Curr Opin Pediatr. 32(1):86-92, 2020
- Calderazzi F et al: Apophyseal avulsion fractures of the pelvis. A review. Acta Biomed. 89(4):470-6, 2018
- Ghanem IB et al: Pediatric avulsion fractures of pelvis: current concepts. Curr Opin Pediatr. 30(1):78-83, 2018
- Schiller J et al: Lower extremity avulsion fractures in the pediatric and adolescent athlete. J Am Acad Orthop Surg. 25(4):251-9, 2017
- Schuett DJ et al: Pelvic apophyseal avulsion fractures: a retrospective review of 228 cases. J Pediatr Orthop. 35(6):617-23, 2015
- Singer G et al: Diagnosis and treatment of apophyseal injuries of the pelvis in adolescents. Semin Musculoskelet Radiol. 18(5):498-504, 2014
- Meyers AB et al: MRI of radiographically occult ischial apophyseal avulsions. Pediatr Radiol. 42(11):1357-63, 2012
- McKinney BI et al: Apophyseal avulsion fractures of the hip and pelvis. Orthopedics. 32(1):42, 2009
- Hébert KJ et al: MRI appearance of chronic stress injury of the iliac crest apophysis in adolescent athletes. AJR Am J Roentgenol. 190(6):1487-91, 2008
- Sanders TG et al: Avulsion injuries of the pelvis. Semin Musculoskelet Radiol. 12(1):42-53, 2008
- Raissaki M et al: Imaging of sports injuries in children and adolescents. Eur J Radiol. 62(1):86-96, 2007
- Rossi F et al: Acute avulsion fractures of the pelvis in adolescent competitive athletes: prevalence, location and sports distribution of 203 cases collected. Skeletal Radiol. 30(3):127-31, 2001
- Carey J et al: MRI of pediatric growth plate injury: correlation with plain film radiographs and clinical outcome. Skeletal Radiol. 27(5):250-5, 1998
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Synonyms
- Acute injury: Avulsion fracture
- Chronic injury: Apophysitis, physeal stress fracture, osteochondrosis, various eponyms specific to site
Definitions
- Apophysis: Nonarticular secondary center of ossification that serves as attachment site for muscle or tendon
- Contributes to bony shape but not length
- Considered epiphyseal equivalent
- Acute injury: Avulsion fracture of osseous &/or cartilaginous apophysis through subjacent physis
- Chronic injury: Repetitive submaximal tensile forces (avulsive microtrauma) exceed rate of repair, leading to local growth plate disturbance (± symptoms)
- Apophysis: Nonarticular secondary center of ossification that serves as attachment site for muscle or tendon
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
- Franz P et al: Tibial tubercle avulsion fractures in children. Curr Opin Pediatr. 32(1):86-92, 2020
- Calderazzi F et al: Apophyseal avulsion fractures of the pelvis. A review. Acta Biomed. 89(4):470-6, 2018
- Ghanem IB et al: Pediatric avulsion fractures of pelvis: current concepts. Curr Opin Pediatr. 30(1):78-83, 2018
- Schiller J et al: Lower extremity avulsion fractures in the pediatric and adolescent athlete. J Am Acad Orthop Surg. 25(4):251-9, 2017
- Schuett DJ et al: Pelvic apophyseal avulsion fractures: a retrospective review of 228 cases. J Pediatr Orthop. 35(6):617-23, 2015
- Singer G et al: Diagnosis and treatment of apophyseal injuries of the pelvis in adolescents. Semin Musculoskelet Radiol. 18(5):498-504, 2014
- Meyers AB et al: MRI of radiographically occult ischial apophyseal avulsions. Pediatr Radiol. 42(11):1357-63, 2012
- McKinney BI et al: Apophyseal avulsion fractures of the hip and pelvis. Orthopedics. 32(1):42, 2009
- Hébert KJ et al: MRI appearance of chronic stress injury of the iliac crest apophysis in adolescent athletes. AJR Am J Roentgenol. 190(6):1487-91, 2008
- Sanders TG et al: Avulsion injuries of the pelvis. Semin Musculoskelet Radiol. 12(1):42-53, 2008
- Raissaki M et al: Imaging of sports injuries in children and adolescents. Eur J Radiol. 62(1):86-96, 2007
- Rossi F et al: Acute avulsion fractures of the pelvis in adolescent competitive athletes: prevalence, location and sports distribution of 203 cases collected. Skeletal Radiol. 30(3):127-31, 2001
- Carey J et al: MRI of pediatric growth plate injury: correlation with plain film radiographs and clinical outcome. Skeletal Radiol. 27(5):250-5, 1998
