Bony projection from the pectineal line of hip bone.OA Case Reviews

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(1) AIIMS, Rishikesh, India

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Summary

Introduction

Superior ramus
of pubic bone has three borders specifically inferior border, anterior border and posterior border often known as
pectineal line. Pectineal line extends from pubic tubercle to iliopubic eminence. One feminine and two male hip bones have been discovered to own bony projections arising from pectineal line lateral to pubic tubercle. The case has been reported for its virgin prevalence.

Case report

Throughout examination of hip bones within the osteology lab of division of anatomy, KG Medical College, Lucknow, UP, India. 3 out 100 hip bones discovered to have bony projection erupting from pectineal line of pubic bone. The size and thickness of those
bony tubercles in feminine hip bone have been 5mm every. The size and thickness in a single male hip bone have been 6mm and 5mm respectively. These measurements in different male hip bone have been 6mm and
4mm.

Dialogue

Pectineal
line which supplies attachment to lacunar ligament, pectineus muscle and conjoint tendon. Bony tubercle arising from pectineal line may be kind as a consequence of ossification of lacunarligament/ pectineus muscle/ conjoint tendon. These bony spurs might impinge on surrounding buildings damaging them creating medical issues. The information shall be of
utmost use to anatomists, radiologists, clinicians and anthropologists.

Introduction

Pubic bone is likely one of the constituent of hip bone. It consists of physique, superior ramus and inferior ramus. Superior ramus is triangular in cross part. It has three borders
specifically, Posterior border often called
pectineal line or pectin pubis
extending from pubic tubercle
to iliopubic eminence, anterior border often known as obturator crest extending from pubic tubercle to acetabular notch and Inferior border.

Pectineal floor
lies between pectineal line
and obturator crest.
Pectineal line offers attachment to conjoint
tendon, lacunar ligament and
pectineus muscle. One feminine and two male hip bones have been discovered to own bony projections arising from pectineal line lateral to pubic tubercle. The bony tubercle might impinge on surrounding buildings inflicting bundle
of issues. The case has been reported for its virgin prevalence.

Case report

Throughout routine examination of hip bones within the osteology lab within the division of anatomy of KGMU, Lucknow, UP, India, three hip bones (one feminine and two male) have been discovered to have bony projection from the pectineal
line. The size and thickness of bony
tubercle on pectineal line in feminine
hip bone (left aspect) have been 5 mm every (Fig. 1).

Determine 1: anterolateral view of feminine hip bone displaying bony projection from pectineal line BT- bony tubercle, PS- pectineal floor, PT- pubic tubercle, OF- obturator foramen

The quantity of this tubercle is 392.4 mm^[3]. The gap of this exostosis from pubic tubercle is 15 mm and 32 mm from pubic
eminence. The size and thickness of those bony out growths in male hip bones (proper aspect) have been 6mm, 5mm and 6mm, 4mm (Fig. 2).

Determine 2: lateral view of male hip bone displaying bony development PS-pectineal floor, PL- pectineal line, BP- bony projection, PT- pubic tubercle, BOP- physique of pubis, IRP- inferior ramus of pubis, OF- obturator foramen, AC- acetabulum F

The quantity of those bony growths of male hip bones was 471 and 301.4 mm^[3] respectively. The distances of those
exosotoses in these proper hip bones of male
from pubic tubercles have been 8 and 15 mm respectively. The distances of those bony spurs from iliopubic
eminence have been 30 and 40 mm. The looks
of this tubercle on X-ray has been displayed in figure-3.

Determine 3: X-ray displaying lateral view of hip bone displaying bony projection from pectineal line BT- bony tubercle, PL- pectineal line, OF- obturator foramen

The form of bony projection is almost cylindrical (Fig.-4).

Determine 4: reveals cylindrical form of bony projection from pectineal line

The incidence of those bony growths was 3% in Indian inhabitants. Contemplating the intercourse in these 100
assorted hip bones, one feminine and two male hip bones have been detected with this bony tubercle. There was no different abnormality in these hip bones.

“This work conforms to the values laid down within the
Declaration of Helsinki (1964). The protocol of this examine has been authorised by the related moral committee associated to our establishment during which it was carried out. All topics gave full
knowledgeable consent to take part on this examine”

Dialogue

Bony development arising from bone are of two types- these arising alongside the joint margins recognized
as osteophytes and people arising from
the websites of attachment of ligaments and tendons often called enthesophytes. Bony development could also be manifestation of bone tumour. Bony projection underneath current examine arises from pectineal line which supplies attachment to lacunar ligament, pectineus muscle and conjoint tendon. As the situation of bony out development is at website of attachment of tendon/ muscle/ ligament, therefore these are examples of enthesophytes as per the definition of Resnick et al.^[1] or often bone tumour. Different examples of those
enthesophytes reported by numerous authors
are the enthesophytes/ bony
projections from obturator foramen^[2], from iliac crest^[3], from exterior occipital protuberance^[4]
and from olecranon strategy of ulna^[5].

Causes

It could be attributable to ossification of lacunar ligament or conjoint tendon or pectineus muscle as a consequence of repetitive pressure on these buildings
throughout frequent biomechanical actions of adduction involving thigh. As repetitive pressure on these buildings
causes lifting of periosteum exposing
the osteogenic layer
containing osteocytes. These
osteocytes lay down the bone forming bony
out development. As noticed underneath current
examine.

New bone can kind at particular person entheses in response to a seronegative spondarthritis^[6]. Extra generally, they’re seen in a number of websites as
a part of the situation first described within the backbone by Forrestier and Rotes-Quero^[7] and now often called diffuse idiopathic skeletal hyperostosis^[8] (DISH). So the reason for this bony out development from pectineal line could also be attributed to a part of
seronegative spondoarthritis
or DISH syndrome.

The third possible trigger could also be calcium metabolism dysfunction.

For the reason that bony tubercle is present in individuals who incessantly adduct their thigh as horse riders or
sports activities requiring frequent adduction of thigh, the defect can be utilized in figuring out such individuals making examine essential to anthropologists and medico authorized specialists.

Clinically, the bony
spurs might impinge on pectineus muscle inflicting spasm and ache throughout adduction of thigh.
It could additionally injury the fibres of conjoint tendon which make the individual prone to inguinal hernia. Furthermore, it might injure the inguinal canal and buildings contained in it i.e. spermatic twine in males and spherical
ligament of uterus in females inflicting ache and spasm of those buildings. Not solely there could also be sensory loss within the area provided by ilioinguinal nerve as a consequence of injury to this nerve but in addition
irregular obturator artery when
current alongside the medial margin of femoral canal is liable to being broken by such a bony projection
resulting in haemorrage. The femoral
sheath and one in every of its content material i.e. femoral veins can also be broken by the tubercle because the vein lie within the
shut proximity of bony projection on pectineal line. The stated bony spur could also be manifestation of bony tumour which is to be confirmed by medical research. However the probabilities of bony spur underneath current examine to be a bony tumour are much less since incidence of bony tumour normally inhabitants may be very much less
as a result of the incidence of bony spur into account is sort of excessive (3%).

X-ray movie (Fig. 3) reveals bony tubercle which can be mistaken for irregular construction like calcification of lymph node. Thus bony
tubercle from pectineal
line could also be confused with some irregular construction in radiographs making it helpful to radiologists.

Thus information of this bony tubercle is of paramount significance to clinicians, anatomists and radiologists,
anthropologists and medico-legal specialists.

References

1.Resnick
D, Niwayama G. Enthesis and enthesopathy: anatomical, pathological and radiological correlation. Radiology 1983; 146:1–9

2.Singh Rajani. Bony spurs projecting within the obturator foramen. Folia Morphol. 2012; 71(2): 125-127

3.Philips
Peter and Deepak M Kamat. Pediatrics marketing consultant reside. www.pediatrics marketing consultant
reside.com Matters facilities/photoclinic 2010

4.Singh
Rajani Bony tubercle at exterior occipital protuberance and distinguished ridges. J Craniofac Surg 2012; 23 (6):1873-4

5.Singh
Rajani Bony projection from the
olecranon strategy of ulna.
Int J Biol Med Res. 2012; 3(4): 2653-2654

6.Niepal
GA, Sitaj S. Enthesopathy. Clin Rheum Dis 1979;5:857–872

7.Julkunnen
H,Heinonen OP,Pyörälä Okay. Hyperostosis of the backbone in an grownup inhabitants. Ann
Rheum Dis 1971;30: 605–612,

8.Resnick
D, Shaul SR,Robins JM. Diffuse idiopathic skeletal hyperostosis (DISH). Forrestiers
illness with additional spinal manifestations. Radiology 1975;115:513–524