Inferior Pubic Rami Stress Fracture in a High School Sprinter: A Case Report

Background Pubic rami stress fractures comprise 1%–2% of all stress fractures and are most often seen in military recruits and long‐distance athletes; they are less commonly reported in short distance athletes. We present an atypical inferior pubic rami stress fracture in a high school sprinter and discuss the current treatment standards along with broad clinical implications of the case. Case Presentation A 15‐year‐old female high school track athlete presented to the sports medicine clinic with right hip pain after she felt a pop around her posterior right hip while running a 100‐m sprint approximately 4 weeks prior. The pain was associated with severe, nonradiating pain, and inability to run afterwards. She came with bilateral hip and pelvic X‐rays from an outside facility that were reported as normal. However, the overread of the images by the sports medicine provider revealed a nondisplaced, subacute right inferior pubic rami stress fracture. The patient was instructed to refrain from running for 3 months. Repeat imaging at 2‐ and 3‐months postinjury revealed progressive healing that clinically correlated with symptom improvement. She then entered a return‐to‐run program with physical therapy and had full return to sport without limitation at 5 months postinjury. Conclusion It is important that sports medicine and orthopedic providers take a holistic approach, considering a broad differential that may be contributing to a patient′s presentation, even if the answer is a known fracture entity in a less frequently reported athletic subgroup.