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Indian J Nucl Med. 2019 Jul-Sep;34(3):256-257. doi: 10.4103/ijnm.IJNM_77_19.

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

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Department of Nuclear Medicine, Kuwait Cancer Control Center, Khaitan, Kuwait.
Department of Nuclear Medicine, Jaber Al-Ahmad Molecular Imaging Center, Kuwait City, Kuwait.


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. 18F-Sodium fluoride (18F-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 18F-NaF positron emission tomography-computed tomography (PET-CT) as magnetic resonance imaging cannot be performed due to obesity. 18F-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. 18F-NaF provides important diagnostic information that might alter treatment options.


18F-sodium fluoride positron emission tomography–computed tomography; adductor insertion avulsion syndrome; stress fracture

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