An uncommon hip pain

Description

A 55-year-old man with a medical history of hypertension and dyslipidaemia, presented to our Hip clinic with non-traumatic left hip pain of five months duration. The pain was  insidious in onset and gradually progressive. The pain  aggravated on , prolonged sitting or squatting, and relieved with rest. There was no history of any constitutional symptoms. The gait of the patient was essentially normal. There was tenderness over the anterior joint line and mild pain on flexion and internal rotation of the hip. There was no limb length discrepancy or wasting of the adjacent muscles. Distal neurovascular examination was normal.

A plain X-ray of the pelvis showed an ill-defined expansile lytic lesion involving the left superior pubic ramus with sclerotic margins and few internal septations (figure 1). Further CT and MRI scans defined the extent of the lesion (figure 2A,B,C and 3A,B,C). Through a Pfannenstiel incision, the lesion in the...

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