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

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 di...

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Autores principales: Kim, Hee Joong, Jeon, Seung Won, Yang, Hanbual, Lee, Sun Hyung, Yoo, Jeong Joong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Orthopaedic Association 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7449850/
https://www.ncbi.nlm.nih.gov/pubmed/32904015
http://dx.doi.org/10.4055/cios20022
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author Kim, Hee Joong
Jeon, Seung Won
Yang, Hanbual
Lee, Sun Hyung
Yoo, Jeong Joong
author_facet Kim, Hee Joong
Jeon, Seung Won
Yang, Hanbual
Lee, Sun Hyung
Yoo, Jeong Joong
author_sort Kim, Hee Joong
collection PubMed
description 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.
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spelling pubmed-74498502020-09-03 Serial Changes in Image Findings of Herniation Pits from the First Appearance Kim, Hee Joong Jeon, Seung Won Yang, Hanbual Lee, Sun Hyung Yoo, Jeong Joong Clin Orthop Surg Original Article 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. The Korean Orthopaedic Association 2020-09 2020-06-03 /pmc/articles/PMC7449850/ /pubmed/32904015 http://dx.doi.org/10.4055/cios20022 Text en Copyright © 2020 by The Korean Orthopaedic Association http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Hee Joong
Jeon, Seung Won
Yang, Hanbual
Lee, Sun Hyung
Yoo, Jeong Joong
Serial Changes in Image Findings of Herniation Pits from the First Appearance
title Serial Changes in Image Findings of Herniation Pits from the First Appearance
title_full Serial Changes in Image Findings of Herniation Pits from the First Appearance
title_fullStr Serial Changes in Image Findings of Herniation Pits from the First Appearance
title_full_unstemmed Serial Changes in Image Findings of Herniation Pits from the First Appearance
title_short Serial Changes in Image Findings of Herniation Pits from the First Appearance
title_sort serial changes in image findings of herniation pits from the first appearance
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7449850/
https://www.ncbi.nlm.nih.gov/pubmed/32904015
http://dx.doi.org/10.4055/cios20022
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