Early symptoms of iliac bone tumor

Some people find that there seems to be a hard object on the right side of their iliac groin, and it hurts when pressed. So they suspect that they have some bone disease and go to the hospital for an imaging examination. The results show that both lower limbs are basically symmetrical, the left acetabulum is relatively shallow and flat, and an irregular low-density shadow can be seen on the right ilium with hardened edges. The imaging diagnosis considered a benign lesion, and later an ECT examination was performed, which diagnosed it as a malignant tumor of the iliac bone.

1. Location of the ilium

The ilium is one of the components of the hip bone, forming the posterior and superior part of the hip bone. It is divided into two parts: the iliac body and the iliac wing. The wide front part is the iliac wing, and the narrow back part is the iliac body. The protrusions below them are called the anterior inferior iliac spine and the posterior inferior iliac spine respectively. There is a deep greater sciatic notch below the posterior inferior iliac spine. The inner surface of the iliac wing is smooth and slightly concave, called the iliac fossa. The lower boundary of the fossa is the prominent arcuate line, and the posterior and superior part is the auricular surface, which forms the sacroiliac joint with the sacrum.

2. CT diagnosis and differentiation of malignant tumors of iliac bone

The pathological types of malignant tumors of the iliac bone are diverse, with the majority originating from the bone marrow. Most CT scans show osteolytic bone destruction and the formation of large soft tissue masses in the pelvic cavity. Those with high malignancy are prone to invade the joints. Most benign tumors and tumor-like lesions are characterized by expansive destruction, with clear boundaries, sclerosis, and no soft tissue masses. Osteochondroma and fibrous dysplasia have characteristic imaging findings. Conclusion The imaging manifestations of malignant tumors of the iliac bone have their own characteristics. After careful observation and comprehensive analysis, most of them can be qualitatively diagnosed.

3. Clinical manifestations of iliac osteoarthritis

1. Pain

Pain is the main symptom of the disease and the main cause of functional disability. It is characterized by insidious onset and continuous dull pain, which often occurs after activities and can be relieved by rest. As the disease progresses, joint movement may be limited by pain, and pain may occur even when the patient is at rest. During sleep, the muscles around the joints are damaged and the protective function of the joints is reduced. The patients cannot limit activities that cause pain as they do when awake, and they may wake up in pain. The sacroiliac joints have extensive nerve innervation, so clinically they present with a variety of pain forms, such as lower back pain, buttock pain, proximal thigh pain, and groin pain. The posterior sacroiliac ligament is innervated by S2-4, and the anterior sacroiliac ligament is innervated by L2-S2. The sacroiliac joint ligaments have dense unmyelinated nerve fibers that constitute the nociceptive sensory system, which is distributed throughout the entire thickness of the joint capsule. Due to the complex innervation of the sacroiliac joint, sacroiliac joint lesions are closely related to low back pain.

2. Morning stiffness

Morning stiffness generally indicates the presence of synovitis, but unlike rheumatoid arthritis, morning stiffness lasts for a relatively short time, generally not exceeding 30 minutes. The symptoms will gradually ease after activities.

3. Other symptoms

Joint contractures, functional disorders, resting pain, and pain that worsens when bearing weight may occur. Dysfunction may occur due to mechanical locking caused by poor joint surface fit, muscle spasm and contraction, joint capsule contraction, and bone spurs.