Sonographic findings of adductor insertion avulsion syndrome with magnetic resonance imaging correlation

Sports-related and overuse conditions may cause painful abnormalities that include muscle and tendon tears, tendon avulsion, bone remodeling, and stress fracture. Adductor insertion avulsion syndrome (AIAS), or thigh splints, is a stress-related avulsive injury of the adductor muscles that occurs at the posteromedial midfemoral diaphysis (Fig. 1). Repetitive avulsive stresses in AIAS may result in a spectrum of findings, which include traction periostitis, osseous stress reaction, and stress fracture. Bone scan findings in AIAS include linear uptake along the medial shaft of the femur. The findings associated with AIAS on magnetic resonance (MR) imaging have been described recently. They include bone marrow edema, adjacent enhancing periostitis, and stress fracture of the posteromedial femoral diaphysis. Musculoskeletal sonography is commonly used to evaluate muscle and tendon injury. To our knowledge, the sonographic findings of AIAS have not been described. We present the sonographic findings in a patient with clinical and MR imaging evidence of AIAS.