Rugby ears (petrified auricles)

Case contributed by Dr Jan Frank Gerstenmaier


A professional rugby player presented to the ED following a head clash during a match. There was loss of consciousness for 10 minutes, but on arrival he had a GCS of 15/15.

Patient Data

Age: 30
Gender: Male

Unenhanced CT brain

Indication: Blunt head injury with 10 minute loss of consciousness.

Incidental finding of petrified auricles, otherwise normal CT brain.

Case Discussion

Petrified auricles as a complication of traumatic auricular haematoma is most common among forwards in the rugby union, but is also seen in participants of other contact sports such as boxing, wrestling, mixed martial arts and vale tudo1. Acrobatic manipulation of ears by teenagers has been described as the aetiology2. The condition has also been described as a complication of bluetooth headset use3.

Other causes of petrified ear include hypothermia and frostbite, or hypercalcaemia secondary to a metabolic or endocrine disorder, such as Addison's disease or hyperparathyroidism (4).

Cauliflower ear is the name given to auricular hematoma that occurs due to blunt trauma, and is left untreated. The precise location of the hematoma is unclear, but positions between the perichondrium and cartilage, or intracartilaginous have been proposed. Complications include infection, cartilage necrosis, contracture, and neocartilage formation, with eventual ossification. This can be prevented by prompt treatment, such as aspiration and silicone splints (5).  

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Case information

rID: 21600
Published: 2nd Feb 2013
Last edited: 16th Jul 2018
System: Head & Neck
Inclusion in quiz mode: Included

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