Ischiopubic synchondrosis asymmetry

Case contributed by Dr Brian Gilcrease-Garcia


Right lower extremity pain

Patient Data

Age: 4 years
Gender: Male

A bubble-like lucency at the right inferior pubic ramus most likely represents an "open" ischiopubic synchondrosis. The contralateral left synchondrosis appears normal. No pelvic or proximal femur fracture.

Recommend correlation with site of child's pain.

Annotated image

Lytic- and expanded-appearing right ischiopubic synchondrosis (blue line), as compared to normal left synchondrosis (yellow).

Case Discussion

The ischiopubic synchondrosis consists of a hyaline cartilage articulation and typically fuses around the time of puberty. Asymmetric enlargement and lucency of the synchondrosis, often simulating a lytic lesion, is a normal variant which may represent an adaptation to mechanical stress. The lesions resolve with skeletal maturation.

This patient was found to have a spiral fracture of the right tibial (Toddler's fracture, not shown), which explained the patient's symptoms.

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Case information

rID: 62472
Published: 19th Aug 2018
Last edited: 20th Aug 2018
Inclusion in quiz mode: Included
Institution: Mallinckrodt Institute of Radiology at Washington University

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