Pitt pit lesion

Case contributed by Dr Safwat Mohammad Almoghazy

Presentation

A known case of metastatic non-small cell lung cancer to brain.

Patient Data

Age: 55Y
Gender: Male
CT
  • Average size liver with no convincing hepatic focal lesion.
  • Right adrenal gland enhancing lesion measuring about 2.5 x 1.5 cm suspicious of metastatic lesion.
  • The left adrenal gland, spleen, gallbladder, biliary tree, pancreas, kidneys, urinary bladder and prostate are unremarkable.
  • No sizable retroperitoneal, mesenteric, pelvic or inguinal lymph node. No overt peritoneal nodule or ascites.
  • Apart from oval or round lucency noted in the anterosuperior aspect of the right femoral neck suggestive of Pitt pit lesion, no suspicious lesion in the visualized bones.

Case Discussion

Pitt pit refers to an oval or round lucency in the anterosuperior aspect of the femoral neck, just distal to the articular surface. It represents a herniation of synovium or soft tissues into the bone through a cortical defect, hence the alternate name synovial herniation pit. They are usually around 5 mm in diameter but can be anywhere between 3 mm and 15 mm.

They are most often an incidental finding and of no clinical significance. There is debate about the exact aetiology of herniation pits. There is some evidence that they may result from femoroacetabular impingement as around 30% of patients with this condition are found to have such a pit 2.  

Pitt pit is one of the skeletal “don’t touch” lesions.

PlayAdd to Share

Case information

rID: 50635
Case created: 15th Jan 2017
Last edited: 19th Jan 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.