Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea.
Clin Orthop Surg. 2020 Sep;12(3):298-303. doi: 10.4055/cios20022. Epub 2020 Jun 3.
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.
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.
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.
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.
疝窝（HPs）曾被认为是偶然发现的，但最近髋关节股骨撞击（FAI）被认为是其形成的可能原因。疝窝骨扫描的发现结果在文献中各不相同：一些显示摄取增加；大多数则没有。我们假设疝窝的影像学表现的连续变化可以解释骨扫描结果的多变性。
4 名患者（5 髋）随访时间超过 7 年。所有患者均为女性，在诊断出乳腺癌后定期进行骨闪烁扫描。在 44 至 64 岁时，骨闪烁扫描首次发现有摄取增加的小病变。在所有病例中，病变均通过磁共振成像证实，并定期进行随访骨闪烁扫描。对 4 个病变还进行了 CT 评估。评估了疝窝大小和骨闪烁扫描中摄取增加的强度的变化。
在骨闪烁扫描上，在之前的骨闪烁扫描阴性后 5-20 个月，在股骨颈处检测到摄取增加的病变。没有与新发现的摄取增加相关的事件或症状。在随访扫描中，摄取强度逐渐降低，在首次出现后 14-50 个月，摄取增加的区域完全消失。在 3 例（2 例患者）中，疝窝大小在随访过程中增加。
所有病例的骨闪烁扫描中摄取增加的区域逐渐消失，疝窝大小增加的情况较为常见。没有出现提示 FAI 的体征或症状的病例。
