Simultaneous Bilateral Anterior Inferior Iliac Spine Avulsion Injury in an Adolescent Cross-Country Runner

INTRODUCTION: Pelvic apophyseal injuries are common in young athletes where muscle strength exceeds the tensile strength of the physis. Sequential bilateral injuries are exceedingly rare, and little is known of their mechanism. CASE PRESENTATION: A 15-year-old male cross-country runner presented with bilateral hip pain after sprint training. The patient describes going “flat out” and “overstriding” before collapsing with immediate pain. MRI imaging confirmed an acute bilateral Anterior Inferior Iliac Spine Injury (AIIS). Conservative management included protected weight-bearing, a hip strengthening program and graded return to play. At 6 months, the patient returned to full sporting activities with no symptoms. CONCLUSION: We present a unique case of bilateral AIIS avulsion that offers insight into the potential mechanisms and adds to the evidence that these injuries may be managed successfully with conservative treatment.