Updated: 6/1/2021

Anterior Inferior Iliac Spine Avulsion (AIIS)

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  • summary
    • An anterior inferior iliac spine (AIIS) avulsion is an apophyseal avulsion injury seen in adolescent athletes as a result of eccentric contraction of the rectus femoris. 
    • Diagnosis is made with pelvis radiographs that shows an avulsion off the AIIS.
    • Treatment is nonoperative with rest, icing, NSAIDs and activity modification. 
  • Epidemiology
    • Demographics
      • most often in adolescents between the ages 14-17
      • males more often than females
      • occurs most often in sports involving kicking
  • Etiology
    • Pathophysiology
      • mechanism
        • typically occurs due to eccentric contraction of the rectus femoris (femoral n.)
          • as hip extends and knee is flexed
          • causes avulsion of its anatomic origin off the pelvis
  • Anatomy
    • Anterior inferior iliac spine
      • a bony prominence just above acetabulum
      • is the origin of the direct head of the rectus femoris (femoral n.)
  • Presentation
    • History
      • sudden "pop" in pelvis
    • Symptoms
      • pain and weakness
    • Physical exam
      • antalgic gait
      • anterior hip pain and hip flexion weakness
  • Imaging
    • Radiographs
      • show avulsion of AIIS
  • Treatment
    • Nonoperative
      • bed-rest, ice, activity modification
        • indications
          • almost all treated nonoperatively
        • technique
          • hip flexed for 2 weeks
            • position lessens stretch of affected muscle and apophysis
          • follow with guarded weight bearing for 4 week
  • Complications
    • Loss of reduction
    • Delayed union

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(OBQ12.30) A 14-year-old hurdler has the immediate onset of right hip pain after his trailing limb struck a hurdle and he falls down. Figure A demonstrates a right hip AP and lateral radiograph. The muscle originating at the injured structure is innervated by which of the following nerves?

QID: 4390
FIGURES:
1

Genitofemoral nerve

1%

(56/6670)

2

Femoral nerve

88%

(5837/6670)

3

Pudendal nerve

1%

(49/6670)

4

Obturator nerve

3%

(202/6670)

5

Superior gluteal nerve

7%

(496/6670)

L 2 A

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