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Case Reports
. 2020 Jul 2;2020(6):rjaa195.
doi: 10.1093/jscr/rjaa195. eCollection 2020 Jun.

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

Ali Amjad  1 , Ahmed Tarek Hafez  1 , Adeel Nawab Ditta  1 , Waqar Jan  1
Affiliations
Case Reports

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

Ali Amjad et al. J Surg Case Rep. .

Abstract

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.

Keywords: Synovial herniation pits; cortical defect; herniation pits.

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Figures

Figure 1
Figure 1
Showed AP view of the pelvis.
Figure 2
Figure 2
Showed lateral view of the hips with pelvis.
Figure 3
Figure 3
Sowed coronal cut of CT hips demonstrating the synovial pit on left and right side.
Figure 4
Figure 4
Showed axial cut of CT hips demonstrating the synovial pit on left and right side.
Figure 5
Figure 5
Showed coronal cut of CT hips demonstrating the synovial pit prominent right side.
Figure 6
Figure 6
Showed T2 signal MRI coronal cut.
Figure 7
Figure 7
Showed T1 signal of MRI hips.
Figure 8
Figure 8
Showed full active flexion of the left hip joint.
Figure 9
Figure 9
Showed external rotation of the left hip joint.
Figure 10
Figure 10
Follow-up AP x-ray pelvis and hips.
See this image and copyright information in PMC

References

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