Radiologic vignette

Polger, M; Aliabadi, P.

doi:10.1002/art.1780360420

Cited by 6 publications

(3 citation statements)

References 3 publications

(4 reference statements)

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“…Collectives with normal adults and incidental collectives ranged from 4.2% [22] to 42.5% [37] referring to patients. In clinical literature, the age of patients ranged from 22 to 62 years in case reports on HPs [21], [23], [25]–[30], and from 14 to 96 years in studies on FAI mentioning HPs (37,45).…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to subchondral cysts, HPs are predominantly localized at the peripheral side of the anterior femoral neck. Further differential diagnoses that should be taken into account are osteoid osteomas [20], [22], [25], [28], [30], [47], malignant diseases such as atypical osseous metastasis [22], [29], [30], [47] and lymphoma [47], inflammatory disease such as Brodie's abscess [20], [22], [25], [29], [30] or iliopsoas tendinitis, -bursitis [30] as well as focal avascular necrosis [22], [30], focal osteoporosis, unspecific trabecular restructuring and degenerative changes [31]. Nevertheless, HPs should be clearly differentiable from these by means of their typical CT appearance as round to oval subcortical/subchondral lesions with encircling sclerotic margin and their typical location at the anterior femoral neck.…”

Section: Discussionmentioning

confidence: 99%

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Herniation Pits in Human Mummies: A CT Investigation in the Capuchin Catacombs of Palermo, Sicily

2012

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Herniation pits (HPs) of the femoral neck were first described in a radiological publication in 1982 as round to oval radiolucencies in the proximal superior quadrant of the femoral neck on anteroposterior radiographs of adults. In following early clinical publications, HPs were generally recognized as an incidental finding. In contrast, in current clinical literature they are mentioned in the context of femoroacetabular impingement (FAI) of the hip joint, which is known to cause osteoarthritis (OA). The significance of HPs in chronic skeletal disorders such as OA is still unclear, but they are discussed as a possible radiological indicator for FAI in a large part of clinical studies.In this paleoradiological study we examined a sample of mummies from the Capuchin Catacombs of Palermo, Sicily, by a mobile computed tomography (CT) scanner. Evaluation of the CT examinations revealed HPs in six out of 16 (37.5%) adult male mummies.The first aim of this study was to compare the characteristics of HPs shown in our mummy collection to the findings described in clinical literature. Thereby CT evaluation revealed that their osseous imaging characteristics are in accordance, consisting of round to oval subcortical lesions at the anterior femoral neck, clearly demarcated by a sclerotic margin.The second aim was to introduce HPs to the paleoradiological and paleopathological methodology as an entity that underwent a renaissance from an incidental finding to a possible radiological indicator of FAI in the clinical situation. As FAI plays an important role in the development of OA of the hip, which is a very common finding in human skeletal remains, HPs should always be considered in paleoradiological evaluation of hip joint diseases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Herniation Pits in Human Mummies: A CT Investigation in the Capuchin Catacombs of Palermo, Sicily

2012

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“…Pitt et al 1) first proposed the term herniation pit to describe this fibrocystic lesion, which has been considered to be the result of mechanical stress from the anterior joint capsule and overlying anterior muscles. The lesion has usually been recognized as incidental and benign, 1 2 3 4 5 6) but recently several reports have suggested that femoroacetabular impingement (FAI) could be the possible cause of the appearance of an HP. 7 8 9 10 11 12 13) …”

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confidence: 99%

Serial Changes in Image Findings of Herniation Pits from the First Appearance

et al. 2020

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Herniation pits (HPs) refer to small, round to oval subcortical radiolucency with a thin sclerotic margin, located typically in the proximal anterosuperior quadrant of the femoral neck. Pitt et al. 1) first proposed the term herniation pit to describe this fibrocystic lesion, which has been considered to be the result of mechanical stress from the anterior joint capsule and overlying anterior muscles. The lesion has usually been recognized as incidental and benign, 1-6) but recently several reports have suggested that femoroacetabular impingement (FAI) could be the possible cause of the appearance of an HP. 7-13) Image findings of HPs are well described in most published reports, but the findings on bone scintigrams are variable: some demonstrated increased uptake and some did not. 1,2,4,6-8,14) Some reports included time-dependent changes in the image findings, 4,6,7,11) but no reports described the time point at which the images were taken after the first development of an HP. In this study, we evaluated long-term serial changes in image findings of HPs from the first appearance. METHODS We conducted this study in compliance with the principles of the Declaration of Helsinki. This retrospective case-series study was approved by the Institutional Review Board

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Clinical imaging characteristics of herniation pits of the femoral neck

Gao¹,

Yin

Ma³

et al. 2009

Orthopaedic Surgery

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Objective: To discuss imaging features of radiographs, computed tomography (CT), magnetic resonance imaging (MRI) and radionuclide imaging of the herniation pit of the femoral neck and their implications for pathogenesis. Methods:Twenty-seven patients with 31 herniation pits of the femoral neck were analyzed. All patients were examined by plain radiographs, 18 by CT, 16 by MRI, and 8 by radionuclide imaging.Results: Thirty-one herniation pits located in the anterior part of the femoral neck or the base of the femoral head were round, oval or '8'-shaped subcortical defects. The pits were usually seen as mild radiolucent areas on radiographs, soft-tissue attenuation with a thin sclerotic rim and a focal cortical perforation on CT and three different signal intensities on MRI. Only one of eight pits revealed mild focal increased uptake on bone radionuclide scans. Conclusion:The occurrence of a herniation pit of the femoral neck correlates closely with the particulars of the structure of the hip joint and corresponding mechanical forces. Round or oval subcortical defects surrounded by a thin sclerotic rim in the superior lateral part of the femoral neck or the anterior lateral base of the femoral head, which are usually normal on radionuclide imaging and have focal cortical perforations on CT, are specific signs for diagnosing herniation pits of the femoral neck.

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Radiologic vignette

Cited by 6 publications

References 3 publications

Herniation Pits in Human Mummies: A CT Investigation in the Capuchin Catacombs of Palermo, Sicily

Herniation Pits in Human Mummies: A CT Investigation in the Capuchin Catacombs of Palermo, Sicily

Serial Changes in Image Findings of Herniation Pits from the First Appearance

Clinical imaging characteristics of herniation pits of the femoral neck

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