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Hip Apophysitis

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1. [Apophyseal Avulsions of the Hip Region in Adolescents].

[Apophyseal Avulsions of the Hip Region in Adolescents]. In daily practice apophyseal avulsions of sportive adolescents are frequently being diagnosed with a time delay and treated heterogeneously.Using the most actual literature and the own experience the current diagnostic and therapeutic strategies are put into perspective with regards of the needs of the adolescent athlete.The apophyseal lesions of the hip area in adolescence are separated in those at the pelvis and those at the proximal (...) trochanter are rare. The cause of injury is a specific acute contracture of the muscle inserting at the affected apophysis during different sporting activities. The treatment of pelvic apophyseal injuries is surgical only in cases with considerable fragment dislocation and in high level athletes. At the femoral side the patients are treated almost always conservatively.Despite of modern and efficient osteosynthetic techniques the treatment of avulsion lesions of the hip region is mainly conservative

2017 Der Orthopade

2. Missed adolescent acetabular apophyseal avulsion with late hip dislocation (PubMed)

Missed adolescent acetabular apophyseal avulsion with late hip dislocation Chronic hip dislocation associated with acetabular apophyseal avulsion in adolescence is rare. Whilst superior acetabular rim fractures have a documented theoretical risk of hip instability, we have not found a case of chronic dislocation resulting from this.We report a case of a 12-year-old healthy boy who initially sustained a missed right acetabular apophyseal avulsion after falling from a quad bike. This was missed (...) on the initial radiograph and a subsequent radiograph following weight bearing a few days later showed a hip dislocation that was also missed. Upon diagnosis at 6 weeks, he underwent open reduction but also required acetabuloplasty to stabilise the hip.At 2 years follow-up, he was enjoying pain free swimming, cycling and walking. His Harris hip score was 87.This case reinforces the need for recognition that in the patient presenting with knee or thigh pain, exclusion of hip pathology is required. It also

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2016 Journal of orthopaedics

3. Bone marrow extract as a growth supplement for human iliac apophyseal chondrocyte culture (PubMed)

Bone marrow extract as a growth supplement for human iliac apophyseal chondrocyte culture Human bone marrow is rich in various growth factors which may support the chondrocyte growth. This study was conducted to compare the culture characteristics of human growth plate chondrocyte in foetal bovine serum (FBS) and human autologous bone marrow extract (BME) in monolayer culture.Iliac crest apophyseal cartilage was harvested from four donors, aged between two and nine years, undergoing hip surgery

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2016 The Indian journal of medical research

4. Ischiofemoral impingement and hamstring dysfunction as a potential pain generator after ischial tuberosity apophyseal fracture non-union/malunion. (PubMed)

age of 18 years (range 14-28) underwent surgery for symptomatic ischiofemoral impingement after ischial tuberosity avulsion fracture. At a mean of 2.2-year follow-up (range 1.7-3.5), the median post-operative mHHS was 89.7 (65.7-96.8) and HOS ADL and Sport subscales were 90 % or greater in all cases. Five patients (50 %) rated their hip as normal, and five patients (50 %) rated their hip as near normal.Malunion or non-union following ischial tuberosity apophyseal fracture can lead to IFI (...) Ischiofemoral impingement and hamstring dysfunction as a potential pain generator after ischial tuberosity apophyseal fracture non-union/malunion. The purpose of this study was to describe the occurrence of ischiofemoral impingement (IFI) and hamstring dysfunction following malunion or non-union of ischial tuberosity apophyseal avulsion fractures and report the short-term outcomes of surgical treatment with regard to alleviating symptomatic extra-articular impingement.All patients who underwent

2015 Knee Surgery, Sports Traumatology, Arthroscopy

5. Detection and Nonoperative Management of Pediatric Developmental Dysplasia of the Hip in Infants up to Six Months of Age

Detection and Nonoperative Management of Pediatric Developmental Dysplasia of the Hip in Infants up to Six Months of Age i DETECTION AND NONOPERATIVE MANAGEMENT OF PEDIATRIC DEVELOPMENTAL DYSPLASIA OF THE HIP IN INFANTS UP TO SIX MONTHS OF AGE EVIDENCE-BASED CLINICAL PRACTICE GUIDELINE Adopted by the American Academy of Orthopaedic Surgeons Board of Directors September 5, 2014 This guideline has been endorsed by the following organizations: ii Disclaimer This Clinical Practice Guideline (...) of Orthopaedic Surgeons iii I. SUMMARY OF RECOMMENDATIONS The following is a summary of the recommendations of the AAOS’ clinical practice guideline on Detection and Nonoperative Management of Pediatric Developmental Dysplasia of the Hip in Infants up to Six Months of Age. All readers of this summary are strongly urged to consult the full guideline and evidence report for this information. We are confident that those who read the full guideline and evidence report will see that the recommendations were

2014 American Academy of Orthopaedic Surgeons

6. Hip Avulsion Fracture

Hip Avulsion Fracture Hip Avulsion Fracture Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Hip Avulsion Fracture Hip Avulsion (...) Fracture Aka: Hip Avulsion Fracture , Anterior Superior Iliac Spine Avulsion Fracture , Anterior Inferior Iliac Spine Avulsion Fracture , ASIS Avulsion Fracture , AIIS Avulsion Fracture , Ischial Tuberosity Avulsion Fracture , Anterior Superior Iliac Spine Fracture , Anterior Inferior Iliac Spine Fracture , Ischial Tuberosity Fracture From Related Chapters II. Epidemiology Occurs most commonly in s III. Pathophysiology Unexpected, explosive muscle contraction Example: "kicking out" at the end of race

2018 FP Notebook

7. Malunited anterior inferior iliac spine fracture as a cause of hip impingement: A case report and review of literature (PubMed)

Malunited anterior inferior iliac spine fracture as a cause of hip impingement: A case report and review of literature Apophyseal injuries of the pelvis have increased recently with increased participation of teenagers in contact sports. Apophyseal fractures of the pelvis should be ruled out from apophysitis, os acetabuli and bony tumors. We report a case of fracture of anterior-inferior iliac spine following indirect injury to the hip in a young football player. The patient failed to get (...) better with nonoperative management and continued to have pain in the left hip and signs and symptoms of impingement. He improved following surgical excision of the heterotopic bone and did not have any evidence of recurrence at 2 years follow- up.

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2016 Chinese Journal of Traumatology

8. Abnormal growth of the proximal femur due to apophyseal-epiphyseal coalescence resulting in coxa valga—a report of two cases in adolescents (PubMed)

Abnormal growth of the proximal femur due to apophyseal-epiphyseal coalescence resulting in coxa valga—a report of two cases in adolescents 21561310 2011 10 17 2018 11 13 1745-3682 82 4 2011 Aug Acta orthopaedica Acta Orthop Abnormal growth of the proximal femur due to apophyseal-epiphyseal coalescence resulting in coxa valga--a report of two cases in adolescents. 507-9 10.3109/17453674.2011.584210 Struijs Peter A A PA Departments of Orthopaedic Surgery, Emma Children’s Hospital, Academic (...) Medical Centre Amsterdam, the Netherlands. p.a.struijs@amc.uva.nl Oostra Roelof-Jan RJ van Rijn Rick R RR Besselaar Philip P PP eng Case Reports Journal Article 2011 05 11 England Acta Orthop 101231512 1745-3674 IM Adolescent Epiphyses diagnostic imaging Femur diagnostic imaging growth & development Femur Head diagnostic imaging Growth Plate diagnostic imaging Hip Dislocation diagnostic imaging etiology Humans Male Radiography 2011 5 13 6 0 2011 5 13 6 0 2011 10 18 6 0 ppublish 21561310 10.3109

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2011 Acta Orthopaedica

9. Greater Trochanter Apophysitis in the Adolescent Athlete. (PubMed)

Greater Trochanter Apophysitis in the Adolescent Athlete. Lower limb traction apophysitis is common in young athletes, occurring at sites such as the tibial tubercle (Osgood-Schlatter disease) and distal patella (Sinding-Larsen-Johansson disease). Around the hip, iliac apophysitis is well recognized, but no cases of greater trochanter apophysitis have previously been reported. We describe the case of a 15-year-old male basketball player with a 2-month history of the right hip pain (...) and significant functional limitation. X-rays revealed widening of the greater trochanter apophysis with subchondral sclerosis, consistent with a diagnosis of traction apophysitis. The patient was treated with a period of relative rest and anti-inflammatory medication. He gradually returned to full athletic activity, including basketball, without recurrence of pain or limitation. We describe the first reported case of traction apophysitis of the greater trochanter. The unique muscular anatomy

2014 Clinical Journal of Sport Medicine

10. Hip Tendonitis and Bursitis (Overview)

pain, such as a hamstring tendinopathy from repetitive activities such as running. Training errors, biomechanical issues, and sudden increases in activity levels are also risk factors. In the adolescent age group, traction injuries such as avulsion fracture and apophysitis can occur and cause difficulties with training and performance. [ , ] The investigation into the cause and treatment of hip overuse injuries can often be frustrating for clinicians and patients alike. Many musculoskeletal (...) . Sports Med . 1998 Apr. 25(4):271-83. . Garrick JG, Webb DR. Sports Injuries: Diagnosis and Management . 2nd ed. Philadelphia, Pa: WB Saunders; 1999. Shbeeb MI, Matteson EL. Trochanteric bursitis (greater trochanter pain syndrome). Mayo Clin Proc . 1996 Jun. 71(6):565-9. . Kujala UM, Orava S, Karpakka J, Leppävuori J, Mattila K. Ischial tuberosity apophysitis and avulsion among athletes. Int J Sports Med . Feb 1997. 18(2):149-55. . Kivlan BR, Martin RL. Functional performance testing of the hip

2014 eMedicine.com

11. Hip Tendonitis and Bursitis (Treatment)

, hamstring, and iliopsoas should be internally fixated. Likewise, large apophyseal avulsions (greater than 2 cm) should be repaired. Intra-articular disorders, such as labral tears, and intra-articular loose bodies need hip arthroscopy to improve an individual's symptoms and level of activity. Other Treatment Low-energy extracorporeal shock wave (ECSW) therapy may be a consideration in the treatment of greater trochanteric pain syndrome. In a study by Furia et al, affected patients either received (...) Hip Tendonitis and Bursitis (Treatment) Hip Tendonitis and Bursitis Treatment & Management: Acute Phase, Recovery Phase Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvODcxNjktdHJlYXRtZW50 processing > Hip

2014 eMedicine.com

12. Hip Tendonitis and Bursitis (Follow-up)

, Orava S, Karpakka J, Leppävuori J, Mattila K. Ischial tuberosity apophysitis and avulsion among athletes. Int J Sports Med . Feb 1997. 18(2):149-55. . Kivlan BR, Martin RL. Functional performance testing of the hip in athletes: a systematic review for reliability and validity. Int J Sports Phys Ther . 2012 Aug. 7(4):402-12. . . Margo K, Drezner J, Motzkin D. Evaluation and management of hip pain: an algorithmic approach. J Fam Pract . 2003 Aug. 52(8):607-17. . . Allison K, Bennell KL, Grimaldi (...) Hip Tendonitis and Bursitis (Follow-up) Hip Tendonitis and Bursitis Follow-up: Return to Play, Complications, Prevention Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvODcxNjktZm9sbG93dXA= processing > Hip

2014 eMedicine.com

13. Hip Tendonitis and Bursitis (Diagnosis)

pain, such as a hamstring tendinopathy from repetitive activities such as running. Training errors, biomechanical issues, and sudden increases in activity levels are also risk factors. In the adolescent age group, traction injuries such as avulsion fracture and apophysitis can occur and cause difficulties with training and performance. [ , ] The investigation into the cause and treatment of hip overuse injuries can often be frustrating for clinicians and patients alike. Many musculoskeletal (...) . Sports Med . 1998 Apr. 25(4):271-83. . Garrick JG, Webb DR. Sports Injuries: Diagnosis and Management . 2nd ed. Philadelphia, Pa: WB Saunders; 1999. Shbeeb MI, Matteson EL. Trochanteric bursitis (greater trochanter pain syndrome). Mayo Clin Proc . 1996 Jun. 71(6):565-9. . Kujala UM, Orava S, Karpakka J, Leppävuori J, Mattila K. Ischial tuberosity apophysitis and avulsion among athletes. Int J Sports Med . Feb 1997. 18(2):149-55. . Kivlan BR, Martin RL. Functional performance testing of the hip

2014 eMedicine.com

14. Hip Avulsion Fracture

Hip Avulsion Fracture Hip Avulsion Fracture Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Hip Avulsion Fracture Hip Avulsion (...) Fracture Aka: Hip Avulsion Fracture , Anterior Superior Iliac Spine Avulsion Fracture , Anterior Inferior Iliac Spine Avulsion Fracture , ASIS Avulsion Fracture , AIIS Avulsion Fracture , Ischial Tuberosity Avulsion Fracture , Anterior Superior Iliac Spine Fracture , Anterior Inferior Iliac Spine Fracture , Ischial Tuberosity Fracture From Related Chapters II. Epidemiology Occurs most commonly in s III. Pathophysiology Unexpected, explosive muscle contraction Example: "kicking out" at the end of race

2015 FP Notebook

15. Overview of musculoskeletal pain

; however, it can affect any joint. Most common presentation for intra-articular pathology of the hip joint; however, referred pain from other sources is not uncommon. Signs and symptoms typically include activity-related pain, pain with movement of the hip, and antalgic gait. Associated most commonly with low-energy injury (e.g., fall from standing height) and osteoporosis or osteopenia. The risk increases significantly with age. Iliotibial band syndrome is the most common cause of lateral knee pain (...) in runners, related to repetitive friction of the iliotibial band sliding over the lateral femoral epicondyle. Runners predisposed to this injury are typically in a phase of overtraining and often have underlying weakness of the hip abductor muscle. Complete separation of 2 articulating bony surfaces, often caused by a sudden impact to the joint. Typically, patients have significant pain on movement and are significantly apprehensive about motion of the affected joint. Diagnosis is usually confirmed

2018 BMJ Best Practice

16. Acutely Limping Child Up To Age 5

[28,29]. Other causes of limp or pain, such as osteochondritis, apophysitis, osteonecrosis, or tumor, may be diagnosed with radiographs, though MRI has better sensitivity for such pathologies [31,32]. US Hips or Lower Extremity US has a limited field of view and has lower accuracy in detection of fractures as compared with radiographs. Weinberg et al [33] showed that clinician-performed US had a sensitivity and specificity of 73% and 92%, respectively, for the evaluation of fractures in children (...) confidence and better delineates abscesses [50,51]. An exception to this may be in infants and younger children with an abundance of nonossified cartilage, in whom infection limited to the intrinsically hyperintense cartilaginous growth plate and epiphyses/apophyses can be occult on unenhanced MRI sequences. Given these considerations, the use of IV contrast may vary with institutional protocol. Variant 5: Child up to age 5. Acute limp. Symptoms localized to lower extremity (not pelvis or hips). Concern

2018 American College of Radiology

17. CRACKCast E176 – Pediatric Musculoskeletal Disorders

(medial epicondylitis) including apophysitis, medial epicondylitis, and osteochondritis dissecans of the radial head and capitellum. Osgood schlatter’s disease – tibial tubercle Sinding-Larsen-Johansson syndrome – inferior patella Sever’s disease apophysitis of the calcaneus due to traction by the gastrocnemius-soleus complex. Hip/Pelvis apophysitis ASIS – tensor fasciae latae; sartorius AIIS – Rectus femoris Iliac crests – abdominal muscles Ischial tuberosities – hamstrings Thanks to Orthobullets (...) ] The growth plate is the weakest part of the bone and is more likely to separate before the adjacent tendon or ligament tears, thereby making sprains uncommon. Of supracondylar fractures, 95% are of the extension type. Displaced fractures are at risk for neurovascular injury and compartment syndrome; the anterior interosseous branch of the median nerve (“A-OK sign”) and the brachial artery are most commonly involved. Developmental dysplasia of the hip affects 1% of children ; all children who are not yet

2018 CandiEM

19. 24 Month Follow-up of Patients With Osgood Schlatter (OSD)

Study Details Study Description Go to Brief Summary: Osgood Schlatter is a common knee condition, affecting approximately 10% of adolescents. OSD is thought to be a growth related pain conditon, and thus resolve after maturation. Despite this, there a lack of prospective data investigating whether this is in fact the case. Condition or disease Intervention/treatment Osgood-Schlatter Disease Apophysitis Other: Activity modification Detailed Description: This is a prospective cohort study of 51 (...) that may manifest as anterior knee pain (Patellofemoral pain, iliotibial band syndrome, sinding-larson-johanson disease). Previous surgery Pain from the hip or back that interferes with activities of daily living. Habitual patella luxations Clinical suspicion of meniscal lesion Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please

2018 Clinical Trials

20. Fracture Fridays: Pop! Goes the apophysis (Re-post)

. On exam he has full range of motion of his back, hips, knees and ankles. There is no neurological deficit and he has normal perfusion of the limb. He ambulates with a slight limp. There is minimal tenderness to palpation in the area of the ischial tuberosity. After a dose of ibuprofen you obtain the following X-Ray. The patient’s X-Ray that you ordered and are now interpreting The Diagnosis The X-Ray is diagnostic for an ischial apophysis avulsion injury. A what you ask? These types of avulsion (...) injuries are sustained acutely, and this particular one mimics a “pulled” hamstring. They may be related to overuse, and chronic stress. Because the muscles are stronger that the apophyseal anchor in pubertal patients, the bone gives way at the point of hamstring insertion as opposed to the ligament or muscle. Patients often feel a “pop” and the pain is immediate, and exacerbated by movement. These injuries occur mostly in the pelvis and lower extremities. The history is invariably similar regardless

2017 PEM Blog

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