Ultrasonographic Diagnosis of an Ischiocondylar Adductor Magnus Partial Tear: An Uncommon Cause of Ischial Pain.

Pain arising from the ischial region is commonly attributed to proximal hamstring injury or ischial bursitis, whereas injury to the ischiocondylar portion of the adductor magnus remains less commonly considered because of its deep location and complex anatomy. We report a 63-year-old woman who developed persistent proximal posterior thigh pain after sprinting, followed by progressive sitting pain despite conservative treatment. High-resolution musculoskeletal ultrasonography revealed focal structural abnormalities of the ischiocondylar portion of the adductor magnus at the tendon insertion and musculotendinous junction that were consistent with a partial tear, accompanied by surrounding inflammatory changes and ischial bursal fluid. The lesion was identified beginning with the short-axis view of the ischial tuberosity, followed by an oblique long-axis view of the ischiocondylar tendon. Conservative rehabilitation, activity modification, and low-level laser therapy resulted in complete symptom resolution without recurrence. This report emphasizes that injury of the ischiocondylar portion of the adductor magnus represents an uncommon differential consideration in patients presenting with proximal posterior thigh or ischial pain. A systematic ultrasound examination with appropriate transducer orientation facilitates accurate diagnosis and appropriate management.