Snapping hip syndrome is a relatively common problem that can be easily managed with conservative treatment. This syndrome can be divided into external, internal and intra-articular types. Internal snapping hip syndrome is the rarest amongst these and its etiology is not well understood. We report a unique case of osteochondroma arising from the anterior inferior iliac spine (AIIS), which caused the internal snapping hip syndrome with hip pain and restriction of activity. This rare case of snapping hip syndrome from the AIIS was treated surgically and the symptoms completely disappeared after excision of the tumor.
Adult ; *Bone Neoplasms ; Female ; *Hip Joint/diagnostic imaging/physiopathology ; Humans ; *Ilium/diagnostic imaging/physiopathology ; *Joint Diseases/etiology/physiopathology ; *Osteochondroma

OBJECTIVETo study the CT axial manifestations of iliolumbar ligament(ILL) and discusses its clinical effects on locating lumbosacral vertebral segments.

METHODSFrom May 2008 to March 2010, 706 adult patients diagnosed lumbar disc disease were performed with axial scans by single slice helical CT. Among the patients, 436 patients were male and 270 patients were female, ranging in age from 25 to 82 years, the median age was 44 years, 78 cases with lumbosacral transitional vertebrae (LSTV) were verified by X-radiography or fluoroscopy. The morphology, origin and insertion, courses of ILL and the relationship of ligament and spinal segments on axial plane images were used to study. The location method of spinal segments by ILL was compared with the other four location methods on CT.

RESULTSOf the 628 cases with normal lumbosacral segmentations sides of ligament, the main part of ILL originated from L5 transverse processes and terminated at the iliac crest, the morphological characters were divided into two types: double band (71.8%, 451/628) and single band (28.2%, 177/628). The tiny branches from posterior and outside edge of L4, lumbar disc were seen simultaneity in 3 cases. The ILL of 78 cases with LSTV all also originated from L5 transverse processes. Using ILL as a marker of the L5 vertebral level, 78 cases with LSTV were correctly numbered, the accuracy rate was higher than the other location methods, there was statistical significance between the location method by ILL and the location method by iliac crest (P < 0.05).

CONCLUSIONThe main part of ILL originates from L5 transverse processes, the anatomic location is relatively steady and can be clearly displayed on axial CT, which can be used as a measure in the idenlification of LSTV in clinical practice, it is worthy to be applied widely in basic-level hospitals.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Ilium ; diagnostic imaging ; Ligaments ; diagnostic imaging ; Lumbar Vertebrae ; diagnostic imaging ; Lumbosacral Region ; Male ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVETo describe the satisfactory intra-iliac paths in Galveston fixation combined with adult human cadaver and radiology study.

METHODSFive adult cadavers with 10 hemisected pelvises were harvested. Parallelly to the Chiotic line, the bone every other 5 mm till the superior rim of the acetabulum (SRA) observing the morphologic characteristics of each cross-sections of the iliac columns was cut. Fifty consecutive and randomly selected patients were measured using three-dimensional computed tomographic reformations. Three paths' valid bony canal lengths (LVBC), contractions' inner widths and positions were evaluated.

RESULTSThe Path A with the longest LVBC (137 +/- 8) mm in male, (130 +/- 11) mm in female was the most satisfactory intra-iliac path according to both adult cadaver and radiographic measurement Path A and B allowed placement of 100 mm and 8 mm implants in male, 80 mm and 6 to 7 mm implants in female patients.

CONCLUSIONThe Path A, passing from the Click point towards the bottom of the anterior inferior iliac spine provides a longer and potentially safer anchor site compared with the traditional path.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Ilium ; anatomy & histology ; diagnostic imaging ; surgery ; Male ; Radiography

BACKGROUNDMany clinical studies have been published involving the use of a high hip center (HHC), achieved good follow-up. However, there is a little anatomic guidance in the literature regarding the amount of bone stock available for initial implant coverage in this area of the ilium. The purpose of this study was to evaluate the thickness and width of the human ilium and related acetabular cup coverage for guiding acetabular component placement in HHC.

METHODSA total of 120 normal hips in 60 cases of adult patients from lower extremities computer tomographic angiography Digital Imaging and Communications in Medicine data were chosen for the study. After importing the data to the mimics software, we chose the cross sections every 5-mm increments from the rotational center of the hip to the cephalic of the ilium according the body sagittal axis, then we measured the thickness and width of the ilium for each cross section in axial plane, calculated the cup coverage at each chosen section.

RESULTSAt the acetabular dome, the mean thickness and width of the ilium were 49.71 ± 4.88 mm and 38.92 ± 3.67 mm, respectively, whereas at 1 cm above the dome, decreased to 41.35 ± 5.13 and 31.13 ± 3.37 respectively, and 2 cm above the dome, decreased to 31.25 ± 4.04 and 26.65 ± 3.43, respectively. Acetabular cup averaged coverage for 40-, 50-, and 60-mm hemispheric shells, was 100%, 89%, and 44% at the acetabular dome, 100%, 43.7%, and 27.5% for 1 cm above the dome, and 37.5%, 21.9%, and 14.2% for 2 cm above the dome.

CONCLUSIONSHHC reconstructions within 1 cm above the acetabular dome will be an acceptable and smaller diameter prosthesis would be better.

Adult ; Aged ; Cross-Sectional Studies ; Female ; Hip Prosthesis ; Humans ; Ilium ; anatomy & histology ; diagnostic imaging ; Male ; Middle Aged ; Radiography

OBJECTIVETo radiographically analyze the osseous fixation zone for the iliac crest external fixation with Schanz screws and in order to guide their placement.

METHODSNine adults with 2.0-mm-slice continuous pelvic axial CT scans were selected as research subjects. Each CT scan data was imported into MIMICS 10.0. The osseous fixation zone the upper portion of the anterior column of the acetabulum which is located between the anterior superior iliac spine and the gluteal medius pillar and between the iliac crest and the acetabulum-for the iliac crest external fixation with Schanz screws was reconstructed into true sagittal and true coronal planes by using the software. Then the measurements were taken on the reconstructed planes with measuring tools. Finally, the measured data was analyzed.

RESULTSThe palpable iliac crest segment, which was of 49.6 mm width and located 16.5 mm posterior to the anterior superior iliac spine could be used to locate the start points of the Schanz screws. Under the above-mentioned iliac crest segment, the osseous zone was deep, got ample bony materials and could intraosseously contain Schanz screws with 5.0 mm diameter. The screws could be safely inserted to a minimal depth of 71.7 mm towards the acetabular dome and to a maximal depth of 143.5 mm posterior to the acetabulum.

CONCLUSIONThe study can guide the effective insertion of the iliac crest Schanz screws. By setting a suitable start point in the above-mentioned iliac crest region and angling correctly relative to the acetabulum,the Schanz screw can be inserted into the relative strong cancellous bone above or posterior to the acetabulum with a considerable depth, to getting more bone engagement.

Adult ; Aged ; Bone Screws ; Female ; Fracture Fixation ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Ilium ; diagnostic imaging ; injuries ; surgery ; Male ; Middle Aged ; Orthopedic Procedures ; Tomography, X-Ray Computed

Arthritis, Juvenile ; diagnosis ; pathology ; Biomarkers, Tumor ; blood ; Biopsy ; Bone Neoplasms ; diagnosis ; pathology ; Child, Preschool ; Diagnostic Errors ; Female ; Hip Joint ; diagnostic imaging ; pathology ; Humans ; Ilium ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Radiography ; Sarcoma, Ewing ; diagnosis ; pathology

Osseous hemangioma is a benign vascular tumor, and it usually occurs in the vertebrae and the skull. However, hemangiomas of flat bones are rare, and there are very few reports that describe the radiologic findings of osseous hemangioma of the ilium. We report a unique case of large cavernous hemangioma mimicking a chondrogenic malignant bone tumor originated from the ilium in a 22-year-old female. The mass showed stippled calcifications, heterogeneous enhancement with thick septa and enhanced soft tissue components on CT and MR, and also this mass demonstrated heterogeneous 2-fluoro [fluorine-18]-2-deoxy-D-glucose (18F-FDG) uptake on 18F-FDG PET/CT.
Bone Neoplasms/radionuclide imaging ; Diagnosis, Differential ; Female ; Fluorodeoxyglucose F18/*diagnostic use ; Hemangioma, Cavernous/*radionuclide imaging ; Humans ; Ilium/*blood supply ; Magnetic Resonance Imaging ; Positron-Emission Tomography and Computed Tomography ; Radiopharmaceuticals/*diagnostic use ; Young Adult

OBJECTIVETo investigate the best effective and accepted path of iliac screws for lumbar sacral spine and pelvis to provide reference for reconstruction.

METHODSFrom Feb. 2009 to Aug. 2009, radiographic data of 50 patients were selected for various reasons, pelvic CT scanning and three-dimensional reconstruction and no positive performance, included 28 males and 22 females with an average age of 41.2 years old, ranging from 19 to 65 years. Designed four paths, in path A, B, C, CLIC (crossing point of Chiotic line and posterior iliac crest, located 24 mm on the top of posterior superior iliac spine) was the starting point for the path in the direction of the upper edge of the acetabulum, anterior inferior iliac spine, acetabulum center; in path D, the posterior superior iliac spine was starting point to direct anterior inferior iliac spine. The length of the screw channel and two narrow points in the screw channel of the bone plate thickness data of each different path were measured and analyzed.

RESULTSThe path A (CLIC point to the upper edge of the acetabulum) and the path B (CLIC point to the AIIS) and the path D (PSIS to AIIS) had correspond length of the screw channel, but the thickness of iliac of path A was thicker than that of path B and D. The iliac thickness of path A (CLIC point to the upper edge of the acetabulum) and the path C (CLIC point to the acetabular center) has no significant difference, but the channel length of path A was significant longer than that of path C.

CONCLUSIONPath A from the CLIC point to the direction of the upper edge of acetabular ilium nail route was the longest path and the iliac bone plate was the most thick, and able to accommodate the relatively longest and most coarse iliac screw, but also bear the greatest tension. It is the best iliac nail route.

Adult ; Aged ; Bone Screws ; Female ; Humans ; Ilium ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; instrumentation ; Tomography, X-Ray Computed ; Young Adult

Apophyseal injuries of the pelvis have increased recently with increased participation of teenagers in contact sports. Apophyseal fractures of the pelvis should be ruled out from apophysitis, os acetabuli and bony tumors. We report a case of fracture of anterior-inferior iliac spine following indirect injury to the hip in a young football player. The patient failed to get better with nonoperative management and continued to have pain in the left hip and signs and symptoms of impingement. He improved following surgical excision of the heterotopic bone and did not have any evidence of recurrence at 2 years follow- up.
Adolescent ; Athletic Injuries ; diagnostic imaging ; surgery ; Femoracetabular Impingement ; diagnostic imaging ; surgery ; Follow-Up Studies ; Football ; injuries ; Fracture Fixation ; adverse effects ; methods ; Fractures, Malunited ; diagnostic imaging ; surgery ; Humans ; Ilium ; diagnostic imaging ; injuries ; surgery ; Male ; Osteotomy ; methods ; Risk Assessment ; Spinal Fractures ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; methods ; Treatment Outcome

OBJECTIVETo study the clinical manifestations, radiologic findings, pathologic diagnosis and differential diagnosis of primary osteosarcoma in elderly patients.

METHODSTwelve cases of primary osteosarcoma occurring in patients older than 60 years were encountered during the period from 1985 to 2010. The clinical manifestations, radiologic features and pathologic findings were studied and the follow-up data were analyzed.

RESULTSThe sites of involvement included long bones (number = 7), ilium (number = 1), craniofacial bones (number = 2) and soft tissue (number = 2). Radiologic examination showed a mixture of osteosclerotic and osteolytic lesions in 10 patients, soft tissue lesions with high-density areas in 2 patients and soft tissue lesions with periosteal reaction in 8 patients. Histologically, most cases showed features of conventional osteosarcoma. There were 2 cases of malignant fibrous histiocytoma-like osteosarcoma, 2 cases of chondroblastic osteosarcoma and 1 case of well-differentiated intraosseous osteosarcoma. Immunohistochemical study played little role in pathologic diagnosis. Ten patients had undergone amputation, including one patient who had received adjuvant chemotherapy beforehand. Nine patients had follow-up information available. Three of them died of lung metastasis and 1 died of cardiovascular disease.

CONCLUSIONSPrimary osteosarcoma rarely occurs in elderly patients and can easily be missed. Correlation with clinical, radiologic and histologic features is important for arriving at a correct diagnosis.

12E7 Antigen ; Aged ; Antigens, CD ; metabolism ; Bone Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Cell Adhesion Molecules ; metabolism ; Chondrosarcoma ; pathology ; Diagnosis, Differential ; Female ; Femoral Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Follow-Up Studies ; Humans ; Ilium ; Lung Neoplasms ; secondary ; Lymphoma ; pathology ; Male ; Middle Aged ; Osteitis Deformans ; pathology ; Osteosarcoma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Radiography ; Soft Tissue Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Vimentin ; metabolism