An apophysis is a secondary ossification center that serves as an insertion site for a tendon or large muscle. Repetitive trauma or stress to one of these areas prior to complete ossification can result in inflammation (apophysitis), especially during a period of rapid bone growth.


Susceptible ages: adolescent, typically 11 to 15 years of age


Sites of possible apophyseal injuries that may be associated with hip pain:

(1) greater trochanter

(2) lesser trochanter

(3) ischeal tuberosity

(4) iliac crest

(5) anterior superior or inferior iliac spine


Clinical features:

(1) The athlete is involved in a sport which involves running.

(2) The athlete complains of hip pain that gradually increases.

(3) The pain is localized and described as dull or aching.

(4) The pain is made worse by running.

(5) The patient assumes a position that reduces tension on the affected muscle (varies with the affected apophysis).

(6) Imaging studies are negative for fracture.


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