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Protrusio acetabuli

MedGen UID:
98369
Concept ID:
C0409495
Anatomical Abnormality
Synonyms: Protrusio acetabulae; Protrusio acetabularis; PROTRUSIO ACETABULI
SNOMED CT: Protrusio acetabuli (59606006)
 
HPO: HP:0003179
Monarch Initiative: MONDO:0008320
OMIM®: 177050

Definition

Intrapelvic bulging of the medial acetabular wall. [from HPO]

Clinical features

From HPO
Hip pain
MedGen UID:
1643075
Concept ID:
C4551516
Sign or Symptom
An unpleasant sensation characterized by physical discomfort (such as pricking, throbbing, or aching) localized to the hip.
Protrusio acetabuli
MedGen UID:
98369
Concept ID:
C0409495
Anatomical Abnormality
Intrapelvic bulging of the medial acetabular wall.
Hip contracture
MedGen UID:
140815
Concept ID:
C0409354
Acquired Abnormality
Lack of full passive range of motion (restrictions in flexion, extension, or other movements) of the hip joint resulting from structural changes of non-bony tissues, such as muscles, tendons, ligaments, joint capsules and/or skin.

Term Hierarchy

Conditions with this feature

Marfan syndrome
MedGen UID:
44287
Concept ID:
C0024796
Disease or Syndrome
FBN1-related Marfan syndrome (Marfan syndrome), a systemic disorder of connective tissue with a high degree of clinical variability, comprises a broad phenotypic continuum ranging from mild (features of Marfan syndrome in one or a few systems) to severe and rapidly progressive neonatal multiorgan disease. Cardinal manifestations involve the ocular, skeletal, and cardiovascular systems. Ocular findings include myopia (>50% of affected individuals); ectopia lentis (seen in approximately 60% of affected individuals); and an increased risk for retinal detachment, glaucoma, and early cataracts. Skeletal system manifestations include bone overgrowth and joint laxity; disproportionately long extremities for the size of the trunk (dolichostenomelia); overgrowth of the ribs that can push the sternum in (pectus excavatum) or out (pectus carinatum); and scoliosis that ranges from mild to severe and progressive. The major morbidity and early mortality in Marfan syndrome relate to the cardiovascular system and include dilatation of the aorta at the level of the sinuses of Valsalva (predisposing to aortic tear and rupture), mitral valve prolapse with or without regurgitation, tricuspid valve prolapse, and enlargement of the proximal pulmonary artery. Severe and prolonged regurgitation of the mitral and/or aortic valve can predispose to left ventricular dysfunction and occasionally heart failure. With proper management, the life expectancy of someone with Marfan syndrome approximates that of the general population.
Ehlers-Danlos syndrome, kyphoscoliotic type 1
MedGen UID:
75672
Concept ID:
C0268342
Disease or Syndrome
PLOD1-related kyphoscoliotic Ehlers-Danlos syndrome (kEDS) is an autosomal recessive generalized connective tissue disorder characterized by hypotonia, early-onset kyphoscoliosis, and generalized joint hypermobility in association with skin fragility and ocular abnormality. Intelligence is normal. Life span may be normal, but affected individuals are at risk for rupture of medium-sized arteries. Adults with severe kyphoscoliosis are at risk for complications from restrictive lung disease, recurrent pneumonia, and cardiac failure.
Osteogenesis imperfecta type III
MedGen UID:
78664
Concept ID:
C0268362
Disease or Syndrome
COL1A1/2 osteogenesis imperfecta (COL1A1/2-OI) is characterized by fractures with minimal or absent trauma, variable dentinogenesis imperfecta (DI), and, in adult years, hearing loss. The clinical features of COL1A1/2-OI represent a continuum ranging from perinatal lethality to individuals with severe skeletal deformities, mobility impairments, and very short stature to nearly asymptomatic individuals with a mild predisposition to fractures, normal dentition, normal stature, and normal life span. Fractures can occur in any bone but are most common in the extremities. DI is characterized by gray or brown teeth that may appear translucent, wear down, and break easily. COL1A1/2-OI has been classified into four types based on clinical presentation and radiographic findings. This classification system can be helpful in providing information about prognosis and management for a given individual. The four more common OI types are now referred to as follows: Classic non-deforming OI with blue sclerae (previously OI type I). Perinatally lethal OI (previously OI type II). Progressively deforming OI (previously OI type III). Common variable OI with normal sclerae (previously OI type IV).
Protrusio acetabuli
MedGen UID:
98369
Concept ID:
C0409495
Anatomical Abnormality
Intrapelvic bulging of the medial acetabular wall.
Multicentric osteolysis nodulosis arthropathy spectrum
MedGen UID:
342428
Concept ID:
C1850155
Disease or Syndrome
Multicentric osteolysis nodulosis and arthropathy (MONA) is a skeletal dysplasia characterized by progressive osteolysis (particularly of the carpal and tarsal bones), osteoporosis, subcutaneous nodules on the palms and soles, and progressive arthropathy (joint contractures, pain, swelling, and stiffness). Other manifestations include coarse facies, pigmented skin lesions, cardiac defects, and corneal opacities. Onset is usually between ages six months and six years (range: birth to 11 years).
Bruck syndrome 1
MedGen UID:
342431
Concept ID:
C1850168
Disease or Syndrome
Bruck syndrome-1 (BRKS1) is characterized by congenital contractures with pterygia, onset of fractures in infancy or early childhood, postnatal short stature, severe limb deformity, and progressive scoliosis (McPherson and Clemens, 1997). Genetic Heterogeneity of Bruck Syndrome Bruck syndrome-2 (BRKS2; 609220) is caused by homozygous mutation in the PLOD2 gene (601865) on chromosome 3q24. Van der Slot et al. (2003) stated that they were unaware of any phenotypic differences between the 2 forms of Bruck syndrome.
Osteogenesis imperfecta type 7
MedGen UID:
343981
Concept ID:
C1853162
Disease or Syndrome
Osteogenesis imperfecta is a connective tissue disorder characterized by bone fragility and low bone mass. OI type VII is an autosomal recessive form of severe or lethal OI (summary by Barnes et al., 2006).
Loeys-Dietz syndrome 2
MedGen UID:
382398
Concept ID:
C2674574
Disease or Syndrome
Loeys-Dietz syndrome (LDS) is characterized by vascular findings (cerebral, thoracic, and abdominal arterial aneurysms and/or dissections), skeletal manifestations (pectus excavatum or pectus carinatum, scoliosis, joint laxity, arachnodactyly, talipes equinovarus, cervical spine malformation and/or instability), craniofacial features (widely spaced eyes, strabismus, bifid uvula / cleft palate, and craniosynostosis that can involve any sutures), and cutaneous findings (velvety and translucent skin, easy bruising, and dystrophic scars). Individuals with LDS are predisposed to widespread and aggressive arterial aneurysms and pregnancy-related complications including uterine rupture and death. Individuals with LDS can show a strong predisposition for allergic/inflammatory disease including asthma, eczema, and reactions to food or environmental allergens. There is also an increased incidence of gastrointestinal inflammation including eosinophilic esophagitis and gastritis or inflammatory bowel disease. Wide variation in the distribution and severity of clinical features can be seen in individuals with LDS, even among affected individuals within a family who have the same pathogenic variant.
Aneurysm-osteoarthritis syndrome
MedGen UID:
462437
Concept ID:
C3151087
Disease or Syndrome
Loeys-Dietz syndrome (LDS) is characterized by vascular findings (cerebral, thoracic, and abdominal arterial aneurysms and/or dissections), skeletal manifestations (pectus excavatum or pectus carinatum, scoliosis, joint laxity, arachnodactyly, talipes equinovarus, cervical spine malformation and/or instability), craniofacial features (widely spaced eyes, strabismus, bifid uvula / cleft palate, and craniosynostosis that can involve any sutures), and cutaneous findings (velvety and translucent skin, easy bruising, and dystrophic scars). Individuals with LDS are predisposed to widespread and aggressive arterial aneurysms and pregnancy-related complications including uterine rupture and death. Individuals with LDS can show a strong predisposition for allergic/inflammatory disease including asthma, eczema, and reactions to food or environmental allergens. There is also an increased incidence of gastrointestinal inflammation including eosinophilic esophagitis and gastritis or inflammatory bowel disease. Wide variation in the distribution and severity of clinical features can be seen in individuals with LDS, even among affected individuals within a family who have the same pathogenic variant.
Osteogenesis imperfecta type 11
MedGen UID:
462568
Concept ID:
C3151218
Disease or Syndrome
Osteogenesis imperfecta (OI) comprises a group of connective tissue disorders characterized by bone fragility and low bone mass. The disorder is clinically and genetically heterogeneous. OI type XI is an autosomal recessive form of OI (summary by Alanay et al., 2010).
Osteogenesis imperfecta type 6
MedGen UID:
481194
Concept ID:
C3279564
Disease or Syndrome
Osteogenesis imperfecta (OI) comprises a group of connective tissue disorders characterized by bone fragility and low bone mass. The disorder is clinically and genetically heterogeneous. Osteogenesis imperfecta type VI is a severe autosomal recessive form of the disorder (Glorieux et al., 2002; Becker et al., 2011).
Loeys-Dietz syndrome 4
MedGen UID:
766676
Concept ID:
C3553762
Disease or Syndrome
Loeys-Dietz syndrome (LDS) is characterized by vascular findings (cerebral, thoracic, and abdominal arterial aneurysms and/or dissections), skeletal manifestations (pectus excavatum or pectus carinatum, scoliosis, joint laxity, arachnodactyly, talipes equinovarus, cervical spine malformation and/or instability), craniofacial features (widely spaced eyes, strabismus, bifid uvula / cleft palate, and craniosynostosis that can involve any sutures), and cutaneous findings (velvety and translucent skin, easy bruising, and dystrophic scars). Individuals with LDS are predisposed to widespread and aggressive arterial aneurysms and pregnancy-related complications including uterine rupture and death. Individuals with LDS can show a strong predisposition for allergic/inflammatory disease including asthma, eczema, and reactions to food or environmental allergens. There is also an increased incidence of gastrointestinal inflammation including eosinophilic esophagitis and gastritis or inflammatory bowel disease. Wide variation in the distribution and severity of clinical features can be seen in individuals with LDS, even among affected individuals within a family who have the same pathogenic variant.

Professional guidelines

PubMed

Lee FY
Instr Course Lect 2022;71:213-220. PMID: 35254784
Van de Velde S, Fillman R, Yandow S
J Bone Joint Surg Am 2006 Mar;88(3):639-46. doi: 10.2106/JBJS.E.00567. PMID: 16510833
McBride MT, Muldoon MP, Santore RF, Trousdale RT, Wenger DR
J Am Acad Orthop Surg 2001 Mar-Apr;9(2):79-88. doi: 10.5435/00124635-200103000-00002. PMID: 11281632

Recent clinical studies

Etiology

Song MH, Kamisan N, Lim C, Shin CH, Yoo WJ, Song HR, Choi IH, Cho TJ
J Pediatr Orthop 2021 Mar 1;41(3):e285-e290. doi: 10.1097/BPO.0000000000001739. PMID: 33534367
Lerch TD, Siegfried M, Schmaranzer F, Leibold CS, Zurmühle CA, Hanke MS, Ryan MK, Steppacher SD, Siebenrock KA, Tannast M
Am J Sports Med 2020 Mar;48(3):661-672. Epub 2020 Jan 21 doi: 10.1177/0363546519897273. PMID: 31961701
Leunig M, Nho SJ, Turchetto L, Ganz R
Clin Orthop Relat Res 2009 Sep;467(9):2241-50. Epub 2009 May 1 doi: 10.1007/s11999-009-0853-3. PMID: 19408062Free PMC Article
Figueras Coll G, Salazar Fernandez de Erenchu J, Roca Burniol J
Hip Int 2008 Jan-Mar;18(1):23-8. doi: 10.1177/112070000801800105. PMID: 18645970
Gusis SE, Riopedre AM, Penise O, Maldonado Cocco JA
Semin Arthritis Rheum 1993 Dec;23(3):155-60. doi: 10.1016/s0049-0172(05)80036-8. PMID: 8122118

Diagnosis

Song MH, Kamisan N, Lim C, Shin CH, Yoo WJ, Song HR, Choi IH, Cho TJ
J Pediatr Orthop 2021 Mar 1;41(3):e285-e290. doi: 10.1097/BPO.0000000000001739. PMID: 33534367
Shirley ED, Sponseller PD
J Am Acad Orthop Surg 2009 Sep;17(9):572-81. doi: 10.5435/00124635-200909000-00004. PMID: 19726741
Van de Velde S, Fillman R, Yandow S
J Bone Joint Surg Am 2006 Mar;88(3):639-46. doi: 10.2106/JBJS.E.00567. PMID: 16510833
Dunlop CC, Jones CW, Maffulli N
Bull Hosp Jt Dis 2005;62(3-4):105-14. PMID: 16022223
McBride MT, Muldoon MP, Santore RF, Trousdale RT, Wenger DR
J Am Acad Orthop Surg 2001 Mar-Apr;9(2):79-88. doi: 10.5435/00124635-200103000-00002. PMID: 11281632

Therapy

Stevenson JD, Kumar VS, Cribb GL, Cool P
Bone Joint J 2018 Jan;100-B(1):101-108. doi: 10.1302/0301-620X.100B1.BJJ-2017-0005.R1. PMID: 29305458
Hanke MS, Steppacher SD, Zurmühle CA, Siebenrock KA, Tannast M
Clin Orthop Relat Res 2016 Oct;474(10):2168-80. doi: 10.1007/s11999-016-4918-9. PMID: 27278677Free PMC Article
Thakkar SC, Foran JR, Mears SC, Sponseller PD
J Arthroplasty 2012 May;27(5):776-82. Epub 2011 Oct 4 doi: 10.1016/j.arth.2011.08.010. PMID: 21975190
Figueras Coll G, Salazar Fernandez de Erenchu J, Roca Burniol J
Hip Int 2008 Jan-Mar;18(1):23-8. doi: 10.1177/112070000801800105. PMID: 18645970
Adib N, Owers KL, Witt JD, Owens CM, Woo P, Murray KJ
Rheumatology (Oxford) 2005 Feb;44(2):219-26. Epub 2004 Oct 19 doi: 10.1093/rheumatology/keh438. PMID: 15494352

Prognosis

Song MH, Kamisan N, Lim C, Shin CH, Yoo WJ, Song HR, Choi IH, Cho TJ
J Pediatr Orthop 2021 Mar 1;41(3):e285-e290. doi: 10.1097/BPO.0000000000001739. PMID: 33534367
Figueras Coll G, Salazar Fernandez de Erenchu J, Roca Burniol J
Hip Int 2008 Jan-Mar;18(1):23-8. doi: 10.1177/112070000801800105. PMID: 18645970
McBride MT, Muldoon MP, Santore RF, Trousdale RT, Wenger DR
J Am Acad Orthop Surg 2001 Mar-Apr;9(2):79-88. doi: 10.5435/00124635-200103000-00002. PMID: 11281632
Steel HH
J Pediatr Orthop 1996 Nov-Dec;16(6):704-18. doi: 10.1097/00004694-199611000-00002. PMID: 8906639
Gusis SE, Riopedre AM, Penise O, Maldonado Cocco JA
Semin Arthritis Rheum 1993 Dec;23(3):155-60. doi: 10.1016/s0049-0172(05)80036-8. PMID: 8122118

Clinical prediction guides

Song MH, Kamisan N, Lim C, Shin CH, Yoo WJ, Song HR, Choi IH, Cho TJ
J Pediatr Orthop 2021 Mar 1;41(3):e285-e290. doi: 10.1097/BPO.0000000000001739. PMID: 33534367
Thakkar SC, Foran JR, Mears SC, Sponseller PD
J Arthroplasty 2012 May;27(5):776-82. Epub 2011 Oct 4 doi: 10.1016/j.arth.2011.08.010. PMID: 21975190
Figueras Coll G, Salazar Fernandez de Erenchu J, Roca Burniol J
Hip Int 2008 Jan-Mar;18(1):23-8. doi: 10.1177/112070000801800105. PMID: 18645970
Sponseller PD, Jones KB, Ahn NU, Erkula G, Foran JR, Dietz HC 3rd
J Bone Joint Surg Am 2006 Mar;88(3):486-95. doi: 10.2106/JBJS.E.00611. PMID: 16510812
McBride MT, Muldoon MP, Santore RF, Trousdale RT, Wenger DR
J Am Acad Orthop Surg 2001 Mar-Apr;9(2):79-88. doi: 10.5435/00124635-200103000-00002. PMID: 11281632

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