The ischium forms the posteroinferior portion of the pelvis, contributing the lower acetabulum, the ischial tuberosity (proximal hamstring origin), the ischial spine (sacrospinous ligament attachment and pudendal nerve landmark), and the ischial ramus (contributing to the obturator foramen). The ischial tuberosity is the weight-bearing surface of the pelvis in sitting.
An expanded entry for Ischium.
| Articulations |
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| Landmarks | |
| Ossification | The ischial apophysis at the ischial tuberosity ossifies at 13-15 years and is the most commonly avulsed pelvic apophysis. |
Ischial tuberosity avulsion fractures in skeletally immature athletes from hamstring traction produce acute buttock pain with hip flexion. Displaced avulsions more than 2 cm may require surgical reattachment. Ischiogluteal bursitis (weaver's bottom) from prolonged ischial tuberosity pressure produces deep seated buttock pain on sitting managed with cushions, injection, and occasionally surgical bursectomy.
Forceful hamstring contraction in adolescent athletes avulses the ischial apophysis.
Narrowing between the ischium and lesser trochanter compresses quadratus femoris, causing deep buttock pain.
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