Distal insertional injury of the adductor may also occur as it inserts on the femur, known as adductor insertion avulsion syndrome and represents a traction injury along the muscle insertion on the femur (similar to tibial shinsplints) as a result of overuse often affecting athletes and military recruits [65-68]. MRI findings vary from periosteal edema to intramedullary signal changes. Radiographs may show periosteal reaction . Based on anatomy, proximal injuries are associated with the adductor brevis, mid-femoral abnormalities are related to adductor longus, and distal posteromedial findings associated with the adductor magnus. Ultrasound may demonstrate periosteal edema, and bone scan may show increased uptake as well . Differential also includes tumor, pseudotumor, and osteomyelitis but clinically thigh splints tend to resolve quickly in response to rest over 1 to 2 months [67,69,70] (Fig. 17).
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