The following pelvic x-ray is from a 15 year old male. He was running when he heard a ‘pop’ sound and collapsed onto the ground, following which he noted pain around the right groin and down to the knee. What can you note in the x-ray?

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The pelvic x-ray shows right ASIS (anterior superior iliac spine) avulsion fracture. There is a triangular bony density adjacent to the anterior superior iliac spine on the right. This is indicative of avulsion at the attachment of the sartorius muscle.

This patient was managed conservatively.

ASIS avulsion:

• Commonly involves young athletes.
• Occurs due to sudden forceful contraction of the sartorius and the tensor fascia lata.
• Patient will often report a ‘pop’ at the time of injury.
• Most cases managed conservatively with rest, crutches, analgesia and early weight bearing.
• Operative indications: fractures with >3mm displacement and painful non-unions.

Reference – http://www.orthobullets.com/sports/3091/anterior-superior-iliac-spine-asis-avulsion

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