Adductor Insertion Avulsion Syndrome with Stress Fracture in Morbidly Obese Patient Diagnosed on (18)F-Sodium Fluoride Positron Emission Tomography-Computed Tomography

Adductor insertion avulsion syndrome, also known as “thigh splints,” is a painful condition affecting the proximal to mid-femur at the insertion of the adductor muscles of the thigh. (18)F-Sodium fluoride ((18)F-NaF) is increasingly used in diagnosing skeletal pain which is not identified on radiographs. We report a case of a 56-year-old morbidly obese woman with left hip pain referred for (18)F-NaF positron emission tomography–computed tomography (PET-CT) as magnetic resonance imaging cannot be performed due to obesity. (18)F-NaF PET-CT shows an increase in tracer uptake at the posteromedial cortex of the upper shaft of left femur. Findings are likely due to adductor insertion avulsion syndrome. (18)F-NaF provides important diagnostic information that might alter treatment options.