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Right acetabular and inferior pubic ramus fractures - THOUGHTS?


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In September, my wife was doing a fitness bootcamp and was running quite a bit. One morning she thought she'd pulled her groin. She is 26, 5'4" and 135#s. No family HX of "osteo" problems. The pain was pretty intense for a few days post "pull." She went to her PCP (who is also a PA). She was given an RX for 500mg Naproxen and told to just rest it and refrain from any sort of physical activity for at least 4 weeks and then come back (no crutches given, etc.). She went back and was still having discomfort with certain movements and was told to wait 2 more weeks. Fast forward to November 23, when an XRAY was finally ordered. Radiology report came back with "Ill defined 1 cm. lucency in the medial most aspect of the right inferior pubic ramus. Recommended further characterization with MRI right hip." Upon visiting with her PCP he asked her if she'd been in an automobile accident because she looked like she'd been "smashed" and had compression sort of fractures. There has been no traumatic event that would cause fractures of this nature. Simply a significant amount of running. Nov. 29th, MRI result: "Corresponding to the x-ray abnormality, there is a subtle nondisplaced fracture of the inferior pubic ramus with surrounding marrow edema and adjacent soft tissue inflammation. There is also a very subtle nondisplaced fracture of the anterior column of the right acetabulum bur the articular cortex does not appear disrupted...no other issues identified." So again, told to just give it time to heal and follow-up in 8 weeks with an xray. Follow-up xray was taken yesterday, and the radiology reports findings are: "Fracture deformity of the right inferior pubic ramus. Right acetabular fracture is not well-demonstrated by xray."

 

You can see the photos of her xrays here: XRAYS- Note captions as to identify which xrays were taken when.

 

Thoughts? How is it that the second set of xrays are so strange and seem so much worse? She hasn't done really anything that would further the injury. At this point should she be seeing an Orthopedic doc? Is there even anything that can be done to fix it?

 

Thanks!

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