Rob Lambert:
Yes – can be mechanical. As well as getting subchondral cysts, degenerative change in joints with a short thick capsule and limited range of motion may be associated with ganglion cysts arising from the joint capsule that erode bone around the perimeter of the "tight" joint. Classic examples are AC joint and symphysis pubis.
Ingrid Kjellin:
SI joints are also abnormal. Chondrocalcinosis in symphysis pubis. Likely a combination of chronic pelvic ring instability and CPPD/pyrophosphate arthropathy.
by the way, having just returned from a rainy week off (having nothing to do with the Hurricane-become-Tropical Storm apparently named for me….and not THE other fabulous MSK radiologist who spells it Hillary)….I finally added nearly 20 new OCADers to the listserv….from around the world.
We are now well past 1400 users.
I’m thinking about my good friend Phil Tirman and this wonderful thing he started way back when….
Hilary
On Mon, Aug 21, 2023 at 11:54 AM hilary wrote:
This is my colleague’s consult.Pt is a 65F with obvious pre-existing symptoms, the neurostimulator is from 2019.
This is done because she was a Pedestrian struck by a car last month.
These images are from a Hip CT, so not centered at the symphysis.
Those smooth erosions and overhanging edge would suggest gout if it were in another location….not sure I’ve seen gout in the pubic symphysis.
Can this just be chronic, mechanical osteitis pubis?
