Case Presentation

The patient is a very pleasant 22-year-old woman who is generally healthy, she recently graduated college and was previously a ballet dancer. She has no serious medical problems and there is no history of injury to the area in question.

The patient has had pain in the left ischium for about two years which has not been getting worse, but not been getting better. She has no problems except for when sitting, and has difficulty because the left hip is sore when sitting

Examination of the area which is the left initial tuberosity reveals no tenderness and no mass. Comparison with the opposite side reveals no side-to-side differences.

There are images from the plain radiographs, bone scan, CT and an MRI. Please click on tthe thumbnails at the right for a larger image. In the left ischium, a lesion is sen adjacent to the inferior medial acetabulum. The lesion is close to the joint surface but no definite connection with the joint space is seen.

Plain radiographs show a lesion adjacent to the left acetabulum, but the lesion is difficult to define.

A bone scan shows no abnormal uptake in the lesion.

CT scan images show that the lesion is lucent, lytic, without matrix mineralization, and there is scalloping, thinning, and even break-through of the cortex.

MRI images show a T1 dark, T2 bright lesion with nonspecific appearance.

The patient underwent CT guided biopsy. The pathology material is shown (or will be shown as soon as it becomes available).

Click on an image to enlarge