PMC4897601_01
19-year-old man with levator ani avulsion. AP radiograph of pelvis shows parasymphyseal bone fragment extending along left pubis (large arrow), mild pubic symphysis diastasis, and transverse fracture of right transverse process (small arrow). There is irregularity along right sacroiliac joint space, suggestive of fracture.
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Findings demonstrated a parasymphyseal bone fragment extending along the left superior pubic ramus (Fig. 1) as well as mild pubic symphysis diastasis.
19-year-old man with levator ani avulsion. CT pelvis in bone window with (a) axial and (b) sagittal views of pelvis demonstrating avulsed fracture of left parasymphsysis (arrows), consistent with levator ani muscle avulsion.
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The CT confirmed a zone one right sacral fracture, a right L5 transverse process fracture, as well as an avulsion fracture along the posterior aspect of the left parasymphysis, consistent with levator ani muscle origin avulsion (Fig. 2).
19-year-old man with levator ani avulsion. CT of pelvis in soft tissue window in (a) axial and (b) sagittal planes showing hematoma in extraperitoneal fat anterior to bladder (arrows) believed to be related to avulsed fracture fragment.
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A CT of the abdomen and pelvis was obtained which demonstrated a hematoma in the presacral space and in the extraperitoneal fat anterior to the bladder (space of Retzius), believed to be related to the parasymphyseal avulsed fracture fragment (Fig. 3).