Pitt’s hernia

Hip
FAI (femoroacetabular impingement)
Pitt’s hernia

A visual journey through orthopedic conditions. Discover the pathology in medical imaging, then in real life. A clear and focused perspective.

Femoral neck hernia or Pitt's hernia is found in 30% of cases in femoroacetabular impingement and resulting from other mechanical stresses.
They most frequently arise on the anterosuperior aspect of the femoral neck, just distal to the articular surface. However, occurrences in the anteroinferior region of the femoral neck have also been reported. These lesions typically measure approximately 5 mm in diameter (range 1–15 mm) and are more often unilateral than bilateral.

Nicolas Reina
CHU Toulouse, FRANCE
Course Director

Professor Reina is Head of Hip and Trauma department, of the University Hospital in Toulouse, France. He holds a PhD in Anthropobiology. He completed a fellowship in Oxford, UK and worked in Mayo Clinic, Rochester for research.

His main focus is hip & pelvis surgery. His clinical practice comprises conservative surgery, primary and complex revision total hip arthroplasty as well as trauma for complex acetabular fractures.

Board member of French Hip Knee Surgery, he is also member of the European Hip Society and the International Board of the American Association of Hip Knee Surgeons. He published more than 150 peer reviewed publications and book chapters, and lectured in various international conferences. His research interests integrate big data in orthopedics, modern care in hip surgery such as minimally invasive techniques, and musculoskeletal system’s ability to adapt to its environment (biomechanics and anthropological variability).

The first look : medical imaging
  • Male patient 37y
  • Chronic left hip pain
  • Anterior, exquisite on FADRI
  • Intra-articular injection test effective
X-ray: FAI due to CAME effect
X-ray: FAI due to CAME effect
ArthroCT: very mild osteoarthritis. Alpha angle > 70°, no labral lesion
ArthroCT: very mild osteoarthritis. Alpha angle > 70°, no labral lesion
Beyond the image : what does it look like in reality ?

➡️ FAI resection
Pitt’s pit is found at cam/neck junction at 3 o’clock

Pitt’s hernia
Pitt’s hernia

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