Ultrasound for diagnosis of apophyseal injuries

  • D. Lazović
  • U. Wegner
  • G. Peters
  • F. Gossé
Sports Medicine


Avulsion injuries of the apophysis is a problem in young athletes. A correct diagnosis is necessary for establishing the appropriate treatment and the rehabilitation program. However, it is often difficult to distinguish between a simple muscle strain and an avulsion fracture. The X-ray examination is helpful only when an ossification center of the apophysis exists. Ultrasonography is considered the suitable diagnostic tool for these cases. From June 1988 to June 1993, 243 young athletes were seen with an anamnestic and clinically suspected apophyseal injury of the lower extremity. In all cases X-ray examination and ultrasound examination were performed. In 80 cases the diagnosis was confirmed by X-ray examination and in 97 by ultrasonography. Four criteria were defined for the sonographic examination: (a) a hypoechogenic zone, (b) increased distance to the apophysis, (c) dislocation of the apophysis, and (d) mobility of the apophysis on dynamic examination. These criteria are correlated to (a) edema, (b) lysis, (c) avulsion, and (d) unstable avulsion of the apophysis. Ultrasonography is a proven technique for the detection of apophyseal injuries. In comparison to X-ray examination, it has the advantages of no radiation exposure, early detection even without ossification center, and dynamic examination.

Key words

Apophyseal injuries Ultrasound X-ray Sports 


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  1. 1.
    Cotta H, Krahl H (1979) Verlaufsformen von Apophysenverletzungen am Becken. Hefte Unfallheilkd 41:98–104Google Scholar
  2. 2.
    De Cuveland E, Holl F (1955) Zur Osteochondropathie der Spina iliaca anterior inferior unter Berücksichtigung traumatischer Entstehungsmöglichkeit. Arch Orthop Unfallchir 47:552–557CrossRefGoogle Scholar
  3. 3.
    Friedebold G, Zilch H, Wilke P (1979) Therapie der Beckenrandbrücke. Hefte Unfalheilkd 140:91–97Google Scholar
  4. 4.
    Gutschank A (1950) Doppelseitige Abrißfraktur des Tuber ossis ischii. Arch Orthop Unfallchir 33:256–259CrossRefGoogle Scholar
  5. 5.
    Klose HH, Schuchard E (1980) Die beckennahen Apophysenabrisse. Orthopaede 9:234–236Google Scholar
  6. 6.
    Krahl H, Steinbrück K (1979) Apophysenverletzungen im Wachstumsalter. Therapiewoche 29:3091–3105Google Scholar
  7. 7.
    Morscher E, Desaulles PA (1964) Die Festigkeit des Wachstumsknorpels in Abhängigkeit von Alter und Geschlecht. Schweiz Med Wochenschr 17:582–587Google Scholar
  8. 8.
    Schlonsky J, Olix M (1972) Functional disability following avulsion fracture of the ischial epiphysis. J Bone Joint Surg [Am] 54:641–644Google Scholar
  9. 9.
    Schneider G (1956) Über isolierte Frakturen des Sitzbeines und Apophysxenlösungen am Tuber ossis ischii. Arch Orthop Unfallchir 48:326–339PubMedCrossRefGoogle Scholar
  10. 10.
    Wooton JR, Cross MG, Holst KWG (1990) Avulsion of the ischial apophysis. J Bone Joint Surg [Br] 72:625–627Google Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • D. Lazović
    • 1
  • U. Wegner
    • 1
  • G. Peters
    • 1
  • F. Gossé
    • 1
  1. 1.Clinic of OrthopedicsMedical School HannoverHannoverGermany

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