MyPACS.net: Radiology Teaching Files > Case 5299091

never visited HIP, SYNOVIAL HERNIATION PIT
Contributed by: Radiology Residency Program Faculty & Staff.
Patient: 50 year old male
History:

11/2/2003 - Right hip radiographs: 50 year old male with right hip pain, no history of trauma.

7/3/2006 - MRI bilateral hips: Chronic bilateral hip pain
Images:[small]larger

Fig. 1: 11/2/2003 - Frog leg lateral projection of the right hip shows a cyst with well defined corticated margins less than 1 cm in diameter in the superolateral portion of the femoral neck.

Fig. 2: Coronal STIR. A 6 mm hyperintense lesion is noted in the anterolateral femoral head/neck correlating with the cystic lesion seen on the comparison radiograph. Small bilateral hip effusions are also seen.

Fig. 3: Axial Fat Saturation T2W image shows 6mm hyperintense lesion in the anterolateral femoral head/neck. Small bilateral hip effusions are also present.
Findings:

11/2/2003 - Frog leg lateral projection of the right hip shows a cyst with well defined corticated margins less than 1 cm in diameter in the superolateral portion of the femoral head/neck.

7/3/2006 - MRI of hips were performed for chronic bilateral hip pain.  A 6 mm T2 hyperintense lesion is noted in the anterolateral femoral head/neck correlating with the cystic lesion seen on the comparison radiograph.  Small bilateral hip effusions are also seen.

Diagnosis: Synovial herniation pit.
Discussion:

Round, well-circumscribed lucent areas located at the anterolateral cortex of the femoral  neck are a normal variant termed synovial herniation pits (Pitt's pit).  These pseudolesions are thought to represent sites of ingrowth of fibrous and cartilaginous elements.  The only confusing feature is that they may be seen to enlarge over time, possibly related to changing mechanisms such as pressure and the abrasive effect of the overlying hip capsule and anterior muscles.

References:

1. Manaster, BJ.  Adult Chronic Hip Pain: Radiographic Evaluation. Radiographics. 2000 Oct (20) Spec No:S3-S25.

2. Fang, C and The, J. Imaging of the hip. Imaging. 15(2003): 205-216.


Submitted by:
Aakash D. Singh, M.D. - PGY-V Radiology Resident
Joseph A. Mendiola, M.D. - Radiologist

Comments:
No comments posted.
Additional Details:

Case Number: 5299091Last Updated: 07-11-2006
Anatomy: Skeletal System   Pathology: Normal/Variants
Modality: Conventional Radiograph, MRExam Date: 11-02-2003Access Level: Readable by all users
Keywords: synovial herniation pit, pitt's pit

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