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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
- Tug injury, tug lesion, pelvis avulsion
Definitions
- Avulsion: disruption of tendon or bone at tendon attachment due to single or repetitive trauma from myotendinous contraction
- Apophysis: accessory center of ossification
- Does not contribute to length of bone
- Apophysitis: "inflammatory" changes at apophysis secondary to trauma
- Injury occurs prior to ossification of apophysis
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
- Albtoush OM et al: Avulsion injuries of the pelvis and hip. Rofo. 192(5):431-40, 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
- Singer G et al: Diagnosis and treatment of apophyseal injuries of the pelvis in adolescents. Semin Musculoskelet Radiol. 18(5):498-504, 2014
- Davis KW: Imaging pediatric sports injuries: lower extremity. Radiol Clin North Am. 48(6):1213-35, 2010
- 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
- Zajick DC et al: Spectrum of MRI findings in clinical athletic pubalgia. Semin Musculoskelet Radiol. 12(1):3-12, 2008
- Vandervliet EJ et al: Sports-related acute and chronic avulsion injuries in children and adolescents with special emphasis on tennis. Br J Sports Med. 41(11):827-31, 2007
- Ouellette H et al: MR imaging of rectus femoris origin injuries. Skeletal Radiol. 35(9):665-72, 2006
- Bui-Mansfield LT et al: Nontraumatic avulsions of the pelvis. AJR Am J Roentgenol. 178(2):423-7, 2002
- 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
- Stevens MA et al: Imaging features of avulsion injuries. Radiographics. 19(3):655-72, 1999
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
- Tug injury, tug lesion, pelvis avulsion
Definitions
- Avulsion: disruption of tendon or bone at tendon attachment due to single or repetitive trauma from myotendinous contraction
- Apophysis: accessory center of ossification
- Does not contribute to length of bone
- Apophysitis: "inflammatory" changes at apophysis secondary to trauma
- Injury occurs prior to ossification of apophysis
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
- Albtoush OM et al: Avulsion injuries of the pelvis and hip. Rofo. 192(5):431-40, 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
- Singer G et al: Diagnosis and treatment of apophyseal injuries of the pelvis in adolescents. Semin Musculoskelet Radiol. 18(5):498-504, 2014
- Davis KW: Imaging pediatric sports injuries: lower extremity. Radiol Clin North Am. 48(6):1213-35, 2010
- 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
- Zajick DC et al: Spectrum of MRI findings in clinical athletic pubalgia. Semin Musculoskelet Radiol. 12(1):3-12, 2008
- Vandervliet EJ et al: Sports-related acute and chronic avulsion injuries in children and adolescents with special emphasis on tennis. Br J Sports Med. 41(11):827-31, 2007
- Ouellette H et al: MR imaging of rectus femoris origin injuries. Skeletal Radiol. 35(9):665-72, 2006
- Bui-Mansfield LT et al: Nontraumatic avulsions of the pelvis. AJR Am J Roentgenol. 178(2):423-7, 2002
- 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
- Stevens MA et al: Imaging features of avulsion injuries. Radiographics. 19(3):655-72, 1999
