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Differential Diagnosis
- Accessory ossicle
- Unfused ossification center
- Avulsion fracture of the anterior inferior iliac spine
![Back Pain After a Fall](https://www.jucm.com/wp-content/uploads/2022/10/11.2022-JUCM-Images-XR2.jpg)
Diagnosis
The image shows an irregular crescentic fragment adjacent to the anterior inferior iliac spine (bone donor site). The correct diagnosis is an avulsion fracture, anterior inferior iliac spine.
Learnings/What to Look for
- Typically, pelvic and hip apophyseal injuries occur in the 14- to 25-year age range
- Usually kicking sports such as soccer are involved, though such injuries are also seen in gymnasts and athletes who engage in jumping sports (such as in track and field)
- Anterior inferior iliac spine avulsion fractures are commonly the result of sudden contraction of the rectus femoris
Pearls for Urgent Care Management
- Treatment is most often nonoperative and includes initial bedrest, ice, and activity modification
- Hip flexed for 2 weeks with the position lessening stretch of the rectus femoris muscle and apophysis
- Follow with guarded weightbearing for 4 weeks and careful return to activity as full recovery may take 4 months
Acknowledgment: Image and case presented by Experity Teleradiology (www.experiety.com/teleradiology).
A 40-Year-Old with Back Pain After a Fall
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