Pubic Bone Aplasia as an Incidental Finding in the Adult Population: Case Report and Review of the Literature

Abstract

Pubic bone aplasia is a rare finding that is either diagnosed as incidental finding or associated with various clinical syndromes. It is usually discovered in early childhood, however, there are few reported cases of late discovery during adulthood. We present a case of a 64-year-old male with unilateral superior pubic rami aplasia, discovered incidentally during workup for sustained trauma. Our patient reported treatment for unilateral hip dislocation in his early childhood and had a history of operated undescended testes ipsilaterally. This exact constellation of pubic rami aplasia, undescended testes and hip dysplasia is unique in the available literature. Even though our patient had a normal life and the pubic aplasia was discovered incidentally, it is important to always assess these patients for systemic involvement, either from the musculoskeletal system or other organs, in order to provide better treatment for them.

Keywords: dysplastic acetabulum; hip dysplasia; pelvic dysplasia; pubic aplasia; pubic bone; pubic bone aplasia; pubic rami aplasia; superior pubic rami; undescended testes; unilateral pubic aplasia.

Figure 1. Anteroposterior (AP) X-ray of the pelvis reveals absence of the right superior pubic rami (yellow arrow).

Note the normal left superior pubic rami (red arrow). Note, also, the dysplastic hip and dysplastic acetabulum ipsilaterally (yellow stars) and concern for dysplastic hip and acetabulum on the contralateral side (red stars). Initial imaging did not reveal abnormality of the femur shaft (up to its middle part, that was depicted).

Figure 2. CT scan of the pelvis (axial view): absence of the left superior pubic rami (yellow arrow).

Note the normal right superior pubic rami (red arrow).

Figure 3. CT 3D reconstruction of the pelvis which shows the absence of the right superior pubic rami (yellow arrows).