34 Avulsion Injuries*

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig B 34-1 Ischial tuberosity. Bilateral chronic avulsions. Note the protuberant bone (closed arrows) and a large, smooth fragment (open arrows).43

• Fig B 34-2 Anterior superior iliac spine (arrowhead).44

• Fig B 34-3 Anterior inferior iliac spine (arrowhead).44

• Fig B 34-4 Symphysis pubis (arrows).43

• Fig B 34-5 Lesser trochanter (solid arrow). A lytic defect representing metastatic cancer is seen at the femur attachment site (open arrow).43

• Fig B 34-6 Greater trochanter (arrows). (A) Plain film. (B) MRI.43

• Fig B 34-7 Segond fracture (arrow).44

• Fig B 34-8 Fibular head (arrow).43

• Fig B 34-9 Tibial eminence (arrow).43

• Fig B 34-10 Posterior cruciate ligament. (A) Axial CT shows minimal displacement of the avulsed fragment (arrows). (B) Sagittal proton-density-weighted MR image shows displacement of an avulsed fragment (arrow).43

• Fig B 34-11 Tibial tuberosity. There is displacement of the proximal base of the epiphysis and extension into the joint (arrows).43

• Fig B 34-12 Inferior pole of the patella (white arrowhead). The black arrowhead points to the site of the avulsion from the abnormally high patella.44

• Fig B 34-13 Calcaneal insufficiency (arrow).43

• Fig B 34-14 Posterior capsule. Curvilinear calcification adjacent to the posterior tibial margin (arrow).43

Fig B 34-15 Anterior capsule. Protuberance of the anterior talus (arrow) where the joint capsule is inserted, indicating a chronic avulsion.43

• Fig B 34-16 Greater tuberosity. (A) Frontal radiograph shows the nondisplaced avulsion (arrows). (B) Coronal oblique T1-weighted MR image shows the fracture to greater advantage (arrow).43

• Fig B 34-17 Lesser tuberosity (arrows).43

• Fig B 34-18 Medial epicondyle (arrowheads).44