XR consult 54M LBP and Lt hip pain

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[PelvicDigit_AxCT2.JPG]
[PelvicDigit_AxCT3.JPG]
[PelvicDigit_CorCT1.JPG]
Likely incidental and definitely benign, shared with me by my colleague.
Prior reports called this old post traumatic heterotopic ossificiation.
My colleague asked “why isn’t this a Pelvic Digit”?
I couldn’t answer his question….on-line images look just like this, but so does residua of old avulsive stress.
How can we tell the difference?

www.ncbi.nlm.nih.gov/pmc/articles/PMC4722546/
[PelvicDigit_CorCT2.JPG]
[PelvicDigit_SagCT1.JPG]
[PelvicDigit_SagCT2.JPG]
Hilary
[Pelvis XR.JPG]
[Lt Hip XR.JPG]

Hilary

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2 thoughts on “XR consult 54M LBP and Lt hip pain”

  1. OCAD
    OCAD

    Ossification of the adductors is associated with horse riding. In theory proximal adductors just called horse riders bone, but distal adductors is cavalry bone. Maybe a difference in style. Have not considered the difference between British and American horse riding styles. Essentially chronic myositis ossificans growing by accretion.

    Tudor

  2. OCAD

    After a typical morning of IT problems and news that ARRS is going to be full Virtual in April 2021, Phil made me laugh with his comment:

    As with so many other things, I’ve never heard of a pelvic digit other than someone with a thumb up their wazoo.

    Carl sent me the following….which I agree with entirely. He later pointed out that the article I attached proved histologically that the “pelvic digit” was more rig-like and, therefore congenital. I admit that I glazed over when I tried to read it…they lost me at “apoptosis”…and I’m not sure if it should convince us that it is congenital rather than acquired post traumatic. Why is it that all of these fingers around the pelvis seem to all occur at tendon origins? Hmmm?

    Hi Hilary,

    I don’t know how to tell the difference. My gut feeling is that most things we call “pelvic digits” may not be congenital, but post traumatic – since they seem to happen at commonly injured tendon attachments. Here’s one that we saw. The CT (done for other reasons) shows the ossification is in the proximal adductors. So, was this congenital, or from a previous, perhaps forgotten, adductor injury? Feel free to share with others…

    –Carl

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