September 1980

Radiological Case of the Month

Author Affiliations

From the Department of Radiology, Kaiser-Permanente Medical Center, Richmond, Calif.

Am J Dis Child. 1980;134(9):885-886. doi:10.1001/archpedi.1980.02130210067018

A 17-year-old high school football player complained of pain involving his left hip after a game. He was referred to the orthopedic department, Kaiser-Permanente Medical Center, Richmond, Calif, after roentgenograms (anteroposterior pelvis, Fig 1) of his left hip had been reviewed by the radiologist and the boy's pediatrician. He had no previous complaints or hospital admissions. No laboratory examinations were obtained.

Denouement and Discussion 

Traumatic Ischial Apophyseolysis  The roentgenographic appearance was pathognomonic for traumatic avulsion of the left ischial apophysis with subsequent exuberant callus reaction. Three years prior to the present injury, the patient was injured during basketball practice. At that time, he noted a sudden, severe pain in his left buttock. Roentgenograms showed a traumatic avulsion of the left ischial apophysis (Fig 2). The pain gradually subsided during the next several months. At the time of his second injury, the mass was palpable on careful examination but caused no discomfort despite its size. Slight functional