MyPACS.net: Radiology Teaching Files > Case 45855595

Last visited 09-05-2010 SYNOVIAL HERNIATION PIT
Contributed by: Jonathan Wood, Resident, Brooke Army Medical Center, Texas, USA.
History: Hip pain.  No further history provided.
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Fig. 1
Findings: Well circumscribed, round hypodense lesion of the right anterosuperior femoral neck with a well defined sclerotic rim.
Diagnosis: Synovial herniation pit
Discussion:

Pathophysiology:

  • Unknown
  • Thought to represent herniation of soft tissue through a periostel defect, eroding into cortex

Significance:

  • Can be seen in up to 1/3 of normal patients
  • Has an increased association with femoroacetabular impingement syndrome, although again pathophysiology is unclear
  • May grown in size

Treatment:

  • None needed
  • If patient with severe femoroacetabular impingement, may consider surgery to resect part of acetabular rim or femoral head/neck, as indicated.
References:

Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular Impingement: Radiographic Diagnosis-What the Radiologist Should Know. AJR 2007; 188:1540.

Pitt M, Graham AR, Shipman JH, Birkby W. Herniation Pit of the Femoral Neck. AJR 1982; 138:1115.

Comments:
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Additional Details:

Case Number: 45855595Last Updated: 09-05-2010
Anatomy: Skeletal System   Pathology: Other
Modality: Conventional RadiographAccess Level: Readable by all users

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