Heard a crack. Initially about one week later, he referred towards the local hospital due to the fact of persisting hip discomfort. On AZD0156 radiographic evaluation, he diagnosed as pelvic boneCopyright 2016 by Korean Hip SocietyHip Pelvis 28(3): 187-190,fracture and encouraged for further evaluation. However, he refused to obtain more examination on account of the alleviation from the hip pain. Though he got rest without having any military instruction for the next six weeks, there was no improvement and tingling sense developed over the posterior PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/21397801 aspect of left thigh. In the course of the initial consultation with the patient, he complained difficulty on sustainedstanding and sitting on a locked position. His body weight, height, hip and lumbar T-score for dual-energy x-ray absorptiometry (DXA) scan had been 76 kg, 183 cm, .7 and .1 respectively. On physical examinations, there was no limitation on selection of motion from the left hip joint. Also he could walk devoid of any discomfort except mild tenderness around the area distal fromABFig. 1. (A) Initial pelvis anteropostrior view from the patient shows the avulsion fracture from the ischial tuberosity. (B) Pelvis frog A B leg view shows the bony fragment in various angle.ABFig. 2. (A) Coronal computed tomography image of pelvis shows the 3500 mm sized bony fragment with multiple small A B fragments. (B) Sagittal computed tomography image of left pelvis shows the bony fragment, 15 mm distance from ischial tuberosity.www.hipandpelvis.or.krBo-Kyu Yang et al. Ischial Tuberosity Avulsion Tension Fracture soon after Repetitive Trainingthe ischial tuberosity. On the radiographs of the pelvis anteroposterior and frog leg view (Fig. 1), there was a 3500 mm sized bony fragment, 15 mm distance from the left ischial tuberosity. Following the patient admitted to our hospital, he had an examination of computed tomography (Fig. 2) and magnetic resonance imaging for rule out pathologic conditions. There was a bony fragment at left ischial tuberosity, which was primarily from conjoined origin of biceps femoris and semitendinosus tendons without any bone marrow edema (Fig. three). All round, he diagnosed as old avulsion fracture at ischial tuberosity. He determined to obtain conservative treatment on situation of a gradual alleviation in the symptom. During the admitted 2 months, he just got rest and higher intensity laser therapy. Thanks to the improvement except discomfort on running, he discharged and returned to his military unit.DISCUSSIONStress fracture can divided into two types, depending on the relations among bone and muscle. A single is fatigue fracture, which generated by excessive muscular strain applied towards the bone of standard strength. The other is insufficiency fracture that occurred when regular muscular strain is applied to weakened bone. It’s critical to distinguish 1 from an additional for understanding the patient’s medical status. These anxiety fractures are well known to take place in soldiers and athletes2). It truly is challenging to distinguish avulsion fracture of ischial tuberosity from hamstring muscle strain considering the fact that its symptoms and injury mechanism are related. However, correct diagnosis is substantial as therapies are unique respectively3). Many authors suggest displacement of 2 to three cm, painful nonunion, exostosis formation, neurologic symptom as an indication for surgery. WhileABCFig. three. (A) Around the coronal T1-weighted image of pelvis, blurred margin of ischial tuberosity and distinct bony fragment A recommend the avulsion stress fracture from the ischial tuberosity. Also, it shows the partial.