Ишиофеморальный синдром как маска апофизита малого вертела у юного спортсмена

Abstract

Non-specific pelvic pain in young athletes can mask atypical disorders that are exceedingly rare among non-athletes. The diagnosis of this syndrome is very problematic, since it may concern different specialties, such as pediatric surgery, pediatrics, traumatology and orthopedics, neurology, gastroenterology, pediatric gynecology, etc. We report a case of lesser trochanter apophysitis in a 12-year-old female gymnast, who had been initially misdiagnosed and the disease had a mask of ischiofemoral syndrome. During the two-year diagnostic search, the athlete has undergone numerous instrumental examinations, some of them for several times (ultrasound, radiography, magnetic resonance imaging, helical computed tomography), as well as general clinical and laboratory examinations; however, many of them did not really narrow down, but expanded the range of diagnostic hypotheses. Treatment gave no positive dynamics. Laboratory and instrumental examinations performed within 2 years excluded a number of pathologies, but did not help to establish a correct diagnosis. Physical examination with the consideration of patient’s professional activity was a key method in the diagnosis of lesser trochanter apophysitis. The patient demonstrated positive dynamics in response to treatment, which confirmed the diagnosis. This case once again demonstrates possible atypical course of the diseases in young athletes and the importance of physical examination, which can significantly narrow down the diagnostic search. Key words: young athletes, pelvic pain syndrome, lesser trochanter apophysitis, ischiofemoral syndrome