Herniation pit of the femoral neck

American Journal of Roentgenology (Impact Factor: 2.73). 07/1982; 138(6):1115-21. DOI: 10.2214/ajr.138.6.1115
Source: PubMed


A round to oval radiolucency surrounded by a thin zone of sclerosis is often identified in the proximal superior quadrant of adult femoral necks. Although usually recognized as incidental and benign, these radiolucencies may be of clinical concern in patients with hip symptoms. The true nature and genesis of these radiolucencies have not been explained. This article relates these radiolucencies to common acquired degenerative changes developing on the surface of the femoral neck in adults (the reaction area) and shows that the radiolucency represents a subcortical pit or cavity formed by herniation of soft tissue contents through defects in the surface of the reaction area. The formation of this pit and its relation to the commonly seen femoral neck radiolucency has not been previously described. The name "herniation pit" is suggested for these lesions.

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    • "Bone notch (Poirier, 1911) Capsular crest (Walmsley, 1915) Cervical crest (Meyer, 1934) Crest Herniation pit (Pitt, 1982) Fibrocystic changes (Leunig, 2005) The notch sign (Petchprapa, 2012) Cervical fossa (Allen, 1882) Irregular depression (Parsons, 1914) Capsular sulcus (Walmsley, 1915) Beta-type Poirirer's facet (Pearson, 1919) Irregular fossa (Meyer, 1934) Trace (Schofield, 1959) Anterior cervical trace (Kostick, 1963) Allen's fossa (Angel, 1964) "

    Full-text · Dataset · Jul 2015
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    • "The thickness in this area is due to crossing of circular and vertical fibers, the zona orbicularis, and the lateral part of the iliofemoral ligament. Further contributing factors might be the indirect pressure applied by the overlying straight head of the rectus femoris muscle and the iliopsoas muscle [15–17]. "
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    ABSTRACT: Introduction. The goal of this study was to research the association of femoral bumps and herniation pits with the overlap-ratio of the cross-over sign. Methods. Pelvic X-rays and CT-scans of 2925 patients with good assessment of the anterior and the posterior acetabular wall and absence of neutral pelvic tilt were enrolled in the investigation. Finally pelvic X-rays were assessed for the presence of a positive cross-over sign, and CT-scans for a femoral bump or a herniation pit. Additionally, if a positive cross-over sign was discovered, the overlap-ratio was calculated. Results. A femoral bump was found in 53.3% (n = 1559), and a herniation pit in 27.2% (n = 796) of all hips. The overlap-ratio correlated positively with the presence of a femoral bump, while a negative correlation between the overlap-ratio and the presence of a herniation pit was found. The latter was significantly more often combined with a femoral bump than without. Conclusions. We detected an increased prevalence of femoral bump with increasing overlap-ratios of the cross-over sign indicating a relation to biomechanical stress. The observed decreased prevalence of herniation pits with increasing overlap-ratios could be explained by reduced mechanical stress due to nontightened iliofemoral ligament in the presence of retroversion of the acetabulum.
    Full-text · Article · Apr 2014
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    • "HPs were defined as cystic lesions located below the anterior cortex of the femoral neck and having a diameter of ≥2 mm [1,13]. The alpha angles of the hips were measured according to the method developed by Notzli et al.[10], in which the anterior extent of the concavity of the femoral neck is defined as the point (point A in Figure 1B) at which the distance from the cortex to the center of the femoral head (point 0 in Figure 1B) first exceeds the radius of the femoral head. "
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    ABSTRACT: Herniation pits (HPs) commonly develop over time at the femoral head--neck junction in adults, but their cause is still under debate. The purpose of study reported here was to investigate the correlation between the prevalence of HPs of the femoral neck and the alpha angle of the hips of healthy Chinese adults, by using computed tomography (CT). Six hundred seventy Chinese adults (representing 1145 hips) who had no known diseases affecting the proximal femur and had no symptoms of femoroacetabular impingement underwent a 64-slice CT scan for medical purposes that included the hip in the scan range. Their CT data were analyzed for the prevalence of HPs in the femoral necks and for hip alpha angles. The overall prevalence of femoral-neck HPs was 12.5% (143 of 1145 hips). The prevalence in the left versus right femoral necks was 12.1% (69 of 569 hips) versus 12.8% (74 of 576 hips). There was no statistically significant difference between the two sides (chi2 = 0.136; p = 0.712). The prevalence of HPs was greater in men than in women (15.9% vs 7.7%; p < 0.01) and greater in adults older than 30 years than in adults younger than 30 years (chi2= 14.547; p < 0.01). The alpha angles were greater in the 143 proximal femora with HPs than in the 1002 without pits (39.95[degree sign] +/- 6.01[degree sign] vs 37.97[degree sign] +/- 5.14[degree sign]; p < 0.01). The prevalence of HPs of the femoral neck in healthy adults was 12.5%, and the prevalence was greater in men than in women. There is a correlation between the prevalence of HPs and the contour of the femoral head--neck junction. The formation of pits may be attributed to the combination of degeneration and morphologic variances in the femoral head--neck junction.
    Full-text · Article · Oct 2013 · BMC Musculoskeletal Disorders
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