Findings
Coronal PDFS, T1, axial PDFS, T1 and T2 weighted MR images reveal minimally displaced avulsion fracture of lesser trochanter of left femur with adjacent soft tissue edema. Normal lesser trochanter of right femur was noted in figures (d) and (f) with non-visualised lesser trochanter of right femur at the expected location.
Diagnosis
Traumatic avulsion fracture of the lesser trochanter of left femur
Summary
Avulsion fractures of the lesser trochanter in children and adolescents are rare. Apophyseal injuries occur most commonly during sport activities. Avulsion fractures of the lesser trochanter are a result of a sudden and forceful contraction of the iliopsoas muscle. A high index of suspicion is required for underlying neoplasm in avulsion fractures of the lesser trochanter in adults. A metastatic disease should be considered until proven otherwise. Non-operative treatment is recommended for all acute apophyseal avulsion fractures of the lesser trochanter. Surgical intervention has to be discussed in the case of symptomatic non-unions and painful exostosis.
Further reads
Ruffing, T., Rückauer, T., Bludau, F., Hofmann, A., Muhm, M., & Suda, A. J. (2018). Avulsion fracture of the lesser trochanter in adolescents. Injury, 49(7), 1278–1281. https://doi.org/10.1016/j.injury.2018.04.030
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