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XRMusculoskeletalConfirmedFRCR 2B
Periacetabular granuloma (particle disease)
Clinical Presentation
Past history right total hip replacement.
- 1Destructive lesion involving the right hemipelvis at the level of the total hip replacement
- 2This is associated with a large soft tissue mass
- 3This is an aggressive lesion and is most likely a metastatic deposit
- 4Solitary plasmacytoma can give a similar radiological appearance
- 5CT is recommended
- 6Right total hip replacement
- 7There is a large lobulated well-defined soft tissue mass measuring 9.2 x 13.5 cm encompassing the right femoral head and neck and extending anteriorly and posteriorly to the hip joint within the iliopsoas bursa
- 8The soft tissue mass also extends medially, smoothly eroding through the acetabulum and inferior and superior pubic rami
- 9The acetabular cup is medially displaced with only a slither of bone overlying the cup
- 10Callus formation at the site of the previous right acetabular fracture.The iliac vessels on the right are abutted by the mass and the vein is compressed.