Radiographic abnormalities of the iliac apophysis in adolescent athletes

Nine of thirteen adolescent patients with a diagnosis of a so-called hip-pointer injury demonstrated a discontinuity of the anterior part of the iliac apophysis on radiographs. Eight of the nine patients improved with conservative treatment and there was total resolution of symptoms in one to eight months. The remaining patient, who was skeletally mature at the time of writing, continued to have recurrent symptoms of discomfort over the iliac crest during athletic activity. Other reports have described the discontinuity as a stress fracture, but the natural history in our patients did not reveal evidence of fracture-healing. However, the discontinuity disappeared at skeletal maturity in all patients. The radiographic discontinuity may be an anatomical anomaly, since it was present bilaterally in all nine patients although only two had symptoms on both sides.