Presentation
Right hip pain.
Patient Data
Cortically based lytic lesion with sclerotic margin in the right femoral neck.
Enhancing low T1 high T2 lesion at the anterior right femoral neck-head junction with background mild cam morphology.
Gluteus minimus tendinopathy.
Case courtesy of Dr Alex Davies.
Cortically based lytic lesion with sclerotic margin in the right femoral neck is smaller than on the most recent x-ray.
Review of a CT abdomen pelvis demonstrates a very small lucent sclerotic-rim lesion in the same location at the right femoral-head neck junction.
Case Discussion
Synovial herniation pits are a "do not touch" lesion with a characteristic appearance that can, just on the first x-ray, be mistaken for more sinister bone lesions. What is a little atypical in this case is the growth but review of prior imaging, which was thankfully available, shows that this is a slow-growing lesion in the typical lesion.
Synovial herniation pits have been associated with cam morphology, as in this case, but a causative relationship is not certain. Growth of synovial herniation pits has been reported in the literature.