Protrusio acetabuli

Protrusio acetabuli
Classification and external resources
Right sided Protrusio acetabuli
ICD-10	M24.7
ICD-9	718.6
DiseasesDB	33283

Protrusio acetabuli is an uncommon defect of the acetabulum. The acetabulum is the socket that receives the femoral head to make the hip joint. The hip bone of the pelvic bone/girdle is composed of three bones, the ilium, the ischium and the pubis. In protrusio deformity, there is medial displacement of the femoral head in that the medial aspect of the femoral cortex is medial to the ilioischial line. The socket is too deep and may protrude into the pelvis. ^[1]

Classification

Protrusio acetabuli is divided into two types, primary and secondary.

Primary protrusio acetabuli

• Characterized by progressive protrusio in middle aged women
• May be associated with OA
• May be familial

Secondary protrusio acetabuli

Causes include:

• Femoral head prosthesis
• Cup arthroplasty
• Septic arthritis
• Central fracture dislocation
• Total hip replacement surgery

Protrusio acetabuli may also be thought of as unilateral or bilateral.

Unilateraly protrusio acetabuli

• Tuberculous arthritis
• Trauma
• Fibrous dysplasia

Bilateral protrusio acetabuli

• Rheumatoid arthritis
• Paget disease
• Osteomalacia

(Source Dahnert's Radiology)

In addition, protrusio acetabuli may be present bilaterally in Paget's disease, Marfan syndrome,^[2] rheumatoid arthritis, ankylosing spondylitis, and osteomalacia;

Signs and Symptoms

• May be asymptomatic
• Limitation of joint range of movement is the earliest sign
• Pain

Natural course

The protrusio may progress until the femoral neck impinges against the pelvis.

Treatment

Arthroscopic surgery (or open joint surgery) is an effective treatment. Joint replacement surgery may be necessary in the case of severe pain or substantial joint restriction. Prominent trabeculae. * Normal sacro-iliac joints and symphysis pubis.

References

1. ↑ Van De Velde S, Fillman R, Yandow S (2006). "The aetiology of protrusio acetabuli. Literature review from 1824 to 2006". Acta Orthop Belg 72 (5): 524–9. PMID 17152413. 
2. ↑ Van de Velde S, Fillman R, Yandow S (2006). "Protrusio acetabuli in Marfan syndrome. History, diagnosis, and treatment". J Bone Joint Surg Am 88 (3): 639–46. doi:10.2106/JBJS.E.00567. PMID 16510833. 

• McBride MT, Muldoon MP, Santore RF, Trousdale RT, Wenger DR (2001). "Protrusio acetabuli: diagnosis and treatment". J Am Acad Orthop Surg 9 (2): 79–88. PMID 11281632.