Ischiopubic synchondrosis asymmetry

Case contributed by Ailbhe M. McDermott
Diagnosis almost certain

Presentation

1 year history of left hip pain

Patient Data

Age: 11 years
Gender: Female

There is an expansile bubble-like lucency without periarticular reaction or cortical breech along the left inferior pubic ramus at the site of the ischiopubic synchrondrosis most likely reflecting ischiopubic synchondrosis asymmetry. The contralateral side is normal. 

Case Discussion

This is an important variant to be aware of to prevent the incorrect diagnosis of a bone tumor. In younger children the enlarged ischiopubic synchondrosis is frequently observed bilaterally, but prior to complete ossification in older children unilateral asymmetry is more commonly observed in the non-dominant lower limb. 

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