Obturator internus avulsion in adolescents: a rare pattern of pelvic avulsion injury.
Saloni Dagar, Mohamed Said, Eric Daniel Fornari et al.
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Case in brief
Two adolescent boys presented with acute hip pain and inability to walk, one after a basketball jump and the other following a fall. Initial pelvic and hip radiographs were normal, but MRI revealed medial displacement and bowing of the obturator internus muscle, extensive edema, and a focal area of hemorrhage, confirming avulsion. Both were treated nonoperatively and returned to high activity after 1 and 2.5 years.
What made this case unusual
The MRI findings showed a distinct pattern of medial displacement and bowing of the obturator internus, which is rarely documented in avulsion injuries.
Diagnostic / clinical pearl
Clinicians should consider obturator internus avulsion in adolescents with acute hip pain and normal radiographs, as MRI can reveal characteristic findings that confirm the diagnosis.
Why it matters
Recognizing this rare injury can prevent unnecessary investigations and facilitate timely management, improving outcomes for affected adolescents.