Symptomatic Herniation Pit of the Femoral Neck: A Case Report

Abstract 

Objective

To discuss herniation pits of the femoral neck as a possible source of hip pain in a young athletic population.

Clinical Features

A 25-year-old former varsity volleyball player sought treatment for recurrent episodes of sharp left hip pain after intense physical activity. Radiographs revealed a small, oval, lobulated radiolucency with a thin sclerotic border in the superolateral aspect of the left femoral neck. Passive internal rotation of the left hip reproduced the complaint. Iliopsoas tendinitis/bursitis tests did not reproduce the complaint.

Intervention and Outcome

The patient reported no significant reduction of hip pain after a variety of conservative therapies including soft tissue therapy, stretching, interferential current, and long-axis distraction.

Conclusion

There is evidence to suggest that herniation pits of the femoral neck are a result of mechanical stress from the overlying joint capsule and iliopsoas tendon. Herniation pits of the femoral neck should be considered a potential cause of hip pain, particularly if the patient is physically active.