The pelvic digit: CT correlation and review of the literature

Heterotopic ossification of the quadratus lumborum muscle

Heterotopic ossification is a benign process of mature laminar bone formation in the soft tissues. A synonymous term used to describe this pathology in muscle is myositis ossificans. The pathogenesis is unclear, but is likely multifactorial. The basic pathology is thought to be ectopic production of osseous tissue as part of a repair process in response to tissue injury. This report describes a case of heterotopic ossification of the quadratus lumborum muscle as an incidental finding. This case highlights that treatment is based on symptoms and conservative management might be appropriate for the asymptomatic patient.

Unilateral hyperplasia of the left posterior arch and associated vertebral schisis at C6 level

We report on a 5-year-old girl with unilateral hyperplasia of the left posterior arch of C6 associated with spina bifida occulta at the same level. Anteroposterior and lateral radiographs of the cervical spine showed hypertrophy of the left lamina as well as overgrowth and elongation of the left spinous process of the sixth cervical vertebra. Computed tomography (CT) examination better depicted this congenital variant and clearly showed the associated schisis of the posterior arch at the same level. Magnetic resonance (MR) imaging examination ruled out other spinal anomalies. The neck pain, the young age of the patient and the local aesthetic abnormality contributed to the surgical indication. To the best of our knowledge, this is the first case in the English literature of unilateral hyperplasia of a posterior cervical arch. Only one previous study has reported a similar congenital anomaly, but it was limited to the left side of the spinous process.

Pelvic digit as a rare cause of chronic hip pain and functional impairment: a case report and review of the literature

Introduction

Pelvic digit is a rare congenital anomaly where bone develops in the soft tissue adjacent to normal skeletal bone. The condition is benign and is usually discovered accidentally. On a plain radiography, pelvic digit typically appears as a rib- or phalanx-like bone structure with a clear cortex and medulla related to the pelvis, often with a pseudoarticulation at its base.

Case presentation

We present the case of a 40-year-old Caucasian man who presented with chronic pain and tenderness over his right hip together with functional impairment in abduction and external rotation. Radiology identified a bony protuberance at the right anterior inferior iliac spine with fusion of the proximal bony nucleus to the adjacent bone. The pelvic digit was surgically removed and the patient was discharged free of symptoms and with complete range of motion in his right hip joint.

Conclusion

It is important to recognize and distinguish a pelvic digit from post-traumatic ossification and avulsion to avoid unnecessary additional investigations.

The pelvic digit "eleventh finger"

Described as asymptomatic and an incidental finding on a plain x-ray film, the "pelvic digit" is a rare congenital anomaly. A 35-year-old man is of a rare symptomatic pelvic digit that warranted surgical excision. Its importance lies in its differentiation from acquired abnormalities due to trauma such as myositis ossificans and avulsion injuries of pelvis. If this entity is kept in mind, unnecessary investigations or interventions can be avoided.

The pelvic digit: a harmless "eleventh" finger

We report a case of a rare congenital anomaly called "pelvic digit". It was incidentally found on a plain radiograph of the pelvis. The radiographic and CT features are described. It is important to be aware of its existence in order to differentiate from acquired abnormalities due to trauma.