Serial Changes in Image Findings of Herniation Pits from the First Appearance.

Publisher: Korean Orthopaedic Association Country of Publication: Korea (South) NLM ID: 101505087 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2005-4408 (Electronic) Linking ISSN: 2005291X NLM ISO Abbreviation: Clin Orthop Surg Subsets: MEDLINE

Original Publication: Seoul : Korean Orthopaedic Association

Femoracetabular Impingement/*diagnostic imaging ; Femoracetabular Impingement/*pathology; Adult ; Disease Progression ; Female ; Femur Neck/diagnostic imaging ; Femur Neck/pathology ; Humans ; Middle Aged ; Time Factors

Backgroud: Herniation pits (HPs) have been considered to be an incidental finding, but recently femoroacetabular impingement (FAI) has been proposed as a possible cause of their formation. The findings on bone scans of HPs are variable in the literature: some showed increased uptake; the majority did not. We hypothesized that serial changes in image findings of HPs would explain the reason for the variable bone scan findings.
Methods: Four patients (5 hips) were followed up for more than 7 years. All patients were women and regularly underwent bone scintigraphy after the diagnosis of breast cancer. Small lesions with increased uptake were first detected on bone scintigraphy at the age of 44 to 64 years. In all cases, the lesions were confirmed by magnetic resonance imaging and follow-up bone scintigrams were taken regularly. Four lesions were also evaluated by computed tomography. Changes in the size of the pits and the intensity of the increased uptake on bone scintigraphy were evaluated.
Results: On the bone scintigrams, the lesions with increased uptake were detected in the femoral neck at 5-20 months after previous negative bone scintigraphy. There had been no events or symptoms associated with the newly detected increased uptake. On follow-up scans, the intensity of the uptake decreased gradually and the areas of increased uptake disappeared completely at 14-50 months after their first appearance. In 3 cases (2 patients), the pit size increased during follow-up.
Conclusions: The areas of increased uptake on bone scintigraphy gradually disappeared in all cases and the increase in pit size was frequent. There was no case in which signs or symptoms suggestive of FAI were noticed.
Competing Interests: CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported.
(Copyright © 2020 by The Korean Orthopaedic Association.)

J Bone Joint Surg Br. 2002 May;84(4):556-60. (PMID: 12043778)
Arthritis Rheum. 1993 Apr;36(4):572-4. (PMID: 8457232)
AJR Am J Roentgenol. 1997 Jan;168(1):149-53. (PMID: 8976938)
AJR Am J Roentgenol. 1992 Nov;159(5):1038-40. (PMID: 1414772)
AJR Am J Roentgenol. 1982 Jun;138(6):1115-21. (PMID: 6979213)
J Orthop Sci. 2017 Jan;22(1):105-111. (PMID: 27720511)
J Bone Joint Surg Am. 2007 Apr;89(4):863-70. (PMID: 17403813)
Radiology. 1989 Jul;172(1):231-4. (PMID: 2740509)
Clin Radiol. 2011 Aug;66(8):742-7. (PMID: 21524414)
Radiology. 2005 Jul;236(1):237-46. (PMID: 15987977)
Korean J Radiol. 2015 Nov-Dec;16(6):1319-25. (PMID: 26576122)
Adv Orthop. 2014;2014:432728. (PMID: 24876972)
J Nucl Med. 2002 Apr;43(4):484-6. (PMID: 11937591)
J Manipulative Physiol Ther. 2005 Jul-Aug;28(6):449-51. (PMID: 16096045)
Orthop Surg. 2009 Aug;1(3):189-95. (PMID: 22009841)
Skeletal Radiol. 2005 Nov;34(11):691-701. (PMID: 16172860)
Clin Nucl Med. 2012 Jul;37(7):682-3. (PMID: 22691513)
Clin Nucl Med. 1983 Jul;8(7):304-5. (PMID: 6225600)

Keywords: Bone scintigram; Herniation pit; Size change; Uptake change

Date Created: 20200909 Date Completed: 20201231 Latest Revision: 20220416

20231215

PMC7449850

10.4055/cios20022

32904015