Synovial Pit of the femoral neck: a rare disease with rare presentations

Abstract

<jats:title>Abstract</jats:title> <jats:p>Herniation pits are small benign oval lesions that were reported to be always lying within the super-lateral femoral neck, and were first described in 1982 by Michael J. Pitt. They are usually a unilateral incidental finding along with asymptomatic course. It was widely believed that herniation pits are a result of invagination of the overlying synovium into small cortical defects in the femoral neck. In our case; the mentioned lesions were found atypically bilaterally at the inferomedial aspect of the neck of femur of a 7-year old child. Radiological scans were efficient to obtain an adequate diagnosis whereas conservative management proved to be sufficient dealing with the lesions. Synovial pits may have atypical clinical and radiological course, and this can raise concerns especially with symptomatic hip that may encourage surgical interventions. However, due to benign course of these lesions, we do not recommend any surgical intervention for such lesions.</jats:p>

Bone marrow lesions: etiology and pathogenesis at the hip

“…One additional pathology which may fit the definition of BML is the herniation pit. These uncommon defects are thought to develop due to pressure on the superolateral femoral neck from the hip capsule, iliofemoral ligament and iliopsoas [ 23 , 24 ]. This pressure then results in herniation of fluid, fibrous, and cartilaginous tissues into the subchondral space [ 24 ].…”

“…This pressure then results in herniation of fluid, fibrous, and cartilaginous tissues into the subchondral space [ 24 ]. Herniation pits are usually identified incidentally via radiographic studies [ 23 ], but they do demonstrate subchondral signal changes when viewed on MRI [ 25 ]. While herniation pits have been linked to diagnosis of FAI, this relationship has been disputed and their clinical implications remain unclear [ 26 ].…”

Semptomatik Kalça Ağrısının Nadir Görülen Bir Nedeni: Sinoviyal Pit: Olgu Bazlı Derleme

“…Genellikle 1 cm'den küçük çaplı, çevresi ince bir skleroz tabaka ile çevrili, radyolüsent yuvarlak lezyonlar şeklinde gözlenirler ve sıklıkla femur boynunun proksimal üst kısmında yerleşirler. Bu radyolusensi görünüm genellikle tesadüfen saptanmasına ve iyi huylu olarak kabul edilmesine rağmen, kalça semptomları olan hastalarda bazen klinik açıdan önemli olabilmektedir 9 . Genellikle tek taraflı olarak yerleşirler.…”