Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Avulsion injuries: an update on radiologic findings

  • Choi, Changwon (Department of Radiology, Inje University Busan Paik Hospital, Inje University College of Medicine) ;
  • Lee, Sun Joo (Department of Radiology, Inje University Busan Paik Hospital, Inje University College of Medicine) ;
  • Choo, Hye Jung (Department of Radiology, Inje University Busan Paik Hospital, Inje University College of Medicine) ;
  • Lee, In Sook (Department of Radiology, Pusan National University Hospital) ;
  • Kim, Sung Kwan (Department of Radiology, Busan Himchan Hospital)
  • Received : 2021.05.07
  • Accepted : 2021.06.22
  • Published : 2021.10.31
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Abstract

Avulsion injuries result from the application of a tensile force to a musculoskeletal unit or ligament. Although injuries tend to occur more commonly in skeletally immature populations due to the weakness of their apophysis, adults may also be subject to avulsion fractures, particularly those with osteoporotic bones. The most common sites of avulsion injuries in adolescents and children are apophyses of the pelvis and knee. In adults, avulsion injuries commonly occur within the tendon due to underlying degeneration or tendinosis. However, any location can be involved in avulsion injuries. Radiography is the first imaging modality to diagnose avulsion injury, although advanced imaging modalities are occasionally required to identify subtle lesions or to fully delineate the extent of the injury. Ultrasonography has a high spatial resolution with a dynamic assessment potential and allows the comparison of a bone avulsion with the opposite side. Computed tomography is more sensitive for depicting a tiny osseous fragment located adjacent to the expected attachment site of a ligament, tendon, or capsule. Moreover, magnetic resonance imaging is the best imaging modality for the evaluation of soft tissue abnormalities, especially the affected muscles, tendons, and ligaments. Acute avulsion injuries usually manifest as avulsed bone fragments. In contrast, chronic injuries can easily mimic other disease processes, such as infections or neoplasms. Therefore, recognizing the vulnerable sites and characteristic imaging features of avulsion fractures would be helpful in ensuring accurate diagnosis and appropriate patient management. To this end, familiarity with musculoskeletal anatomy and mechanism of injury is necessary.

Keywords

Acknowledgement

This work was supported by the 2019 Inje University research grant.

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