Citation, DOI, disclosures and article data
Citation:
Weerakkody Y, Silverstone L, Knipe H, et al. Pelvic digit. Reference article, Radiopaedia.org (Accessed on 29 Mar 2025) https://doi.org/10.53347/rID-10952
Pelvic digit, also known as a pelvic rib, pelvic finger, or 11th finger, is a rare congenital abnormality where there is a development of bony tissue in the soft tissue pelvis and less commonly in the abdomen. They can be associated with one or more pseudoarticulations. They are usually unilateral, though one case of bilateral pelvic digits has been reported 5.
Pathogenesis is unknown but is thought to occur during early embryogenesis from the non-fusion of the vertebral column and the superior part of the coccyx and subsequent independent development of the intervening cartilaginous segment 4.
Treatment and prognosis
It is a benign entity and one of the so-called “do not touch” lesions and if incidentally discovered no further investigations are required. On rare occasions, it can provoke localised pain 7.
History and etymology
The condition was first described by Sullivan and Cornwell in 1974 when a rib was noted radiologically in a girl 6. Most cases of pelvic digit variations occur in the ilium.
General imaging differential considerations include:
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1. Van Breuseghem I. The Pelvic Digit: A Harmless "Eleventh" Finger. Br J Radiol. 2006;79(945):e106-7. doi:10.1259/bjr/17378249 - Pubmed
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2. Van Derslice R, Gembala R, Zekavat P. Case Report. Pelvic Rib/Digit. Spine (Phila Pa 1976). 1992;17(10):1264-6. doi:10.1097/00007632-199210000-00026 - Pubmed
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3. McGlone B, Hamilton S, FitzGerald M. Pelvic Digit: An Uncommon Developmental Anomaly. Eur Radiol. 2000;10(1):89-91. doi:10.1007/s003300050010 - Pubmed
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4. Pandey V, Thakur A, Acharya K, Rao P. The Pelvic Digit "Eleventh Finger". Indian J Orthop. 2009;43(1):97-8. doi:10.4103/0019-5413.45332 - Pubmed
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5. Hoeffel C, Hoeffel J, Got I. Bilateral Pelvic Digits. A Case Report and Review of the Literature. Rofo. 1993;158(3):275-6. doi:10.1055/s-2008-1032648 - Pubmed
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6. Sullivan D & Cornwell W. Pelvic Rib. Report of a Case. Radiology. 1974;110(2):355-7. doi:10.1148/110.2.355 - Pubmed
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7. Maegele M. Pelvic Digit as a Rare Cause of Chronic Hip Pain and Functional Impairment: A Case Report and Review of the Literature. J Med Case Rep. 2009;3(1):139. doi:10.1186/1752-1947-3-139 - Pubmed
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8. Milankov M, Harhaji V, Gojković Z, Drapsin M. Heterotopic Ossification Following Surgical Treatment of Avulsion Fracture of the Anterior Inferior Iliac Spine. Med Pregl. 2011;64(11-12):593-6. doi:10.2298/mpns1112593m - Pubmed
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