Pitt pit

Case contributed by Dr Aneta Kecler - Pietrzyk

Presentation

25 year old female patient referred by ED post fall 2 weeks earlier with ongoing pubic symphysis pain since. No prior surgical or medical history. Normal range of movement of both hips on examination.

Patient Data

Age: 25
Gender: Female
X-ray

There is a synovial herniation pit, also known as Pitt pit, at the anterolateral aspect of the right femoral head neck junction which was not present on the prior radiograph from 5 years before (not shown).

In addition, there is abnormal bony spurring at the bilateral femoral head neck junctions, left greater than right, consistent with bilateral cam-type femoroacetabular impingement anatomy.

No significant hip joint space loss.

Annotated image

Asynovial herniation pit also known as Pitt pit at the anterolateral aspect of the right femoral head neck junction (white arrow).

Abnormal bony spurring at the bilateral femoral head neck junctions, left greater than right, concerning for bilateral cam-type femoroacetabular impingement (black arrows).

Case Discussion

Femoroacetabular impingement (FAI) syndrome is a group of morphological changes involving femoral head and/or neck combined with pain and/or range of movement which causes early degenerative disease.

There are three types of FAI:

  • pincer
  • cam (presented in this case)
  • mixed

A "cam" is a part of camshaft a car's engine part. It looks like a bump on a stick - like a shaft, similarly to abnormality seen in the area of femoral neck in FAI. 

Pitt pit is a synovial herniation cyst localised typically in antero superior aspect of the femoral neck. Its significance is debatable. In most of the cases Pitt pit has no clinical significance however in some cases it is associated with femoroacetabular impingement.

In this case, Pitt pit helped to reach a diagnosis. After spotting the synovial cyst reporter investigated in detail the femoral heads, which were abnormal. 

The patient was referred to the Orthopaedic clinic for review and treatment plan.

PlayAdd to Share

Case information

rID: 54683
Case created: 22nd Jul 2017
Last edited: 24th Jul 2017
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.