# A symptomatic pelvic digit with surgical and pathological correlation

## TL;DR

This paper presents a rare case of a pelvic digit causing erectile dysfunction and pain, diagnosed and treated through imaging and surgery.

## Contribution

The paper provides a detailed case report with surgical and pathological confirmation of a symptomatic pelvic digit.

## Key findings

- Pelvic radiographs showed a 2-cm ossified cannulated structure from the right ischiopubic ramus.
- MRI and CT scans confirmed the pelvic digit's location and structure near erectile tissues and muscles.
- Surgical resection and pathology confirmed the diagnosis and ruled out other similar conditions.

## Abstract

Pelvic digits (also known as pelvic fingers or pelvic ribs) are rare supernumerary benign bony lesions. Most of them are asymptomatic but, when symptomatic, they can pose a diagnostic challenge. We hereby present a case of a pelvic digit responsible for an organic erectile dysfunction and a disabling pain in the sitting position. Pelvic radiographs showed a 2-cm ossified cannulated structure emerging from the right ischiopubic ramus, extending down into the right perineal soft tissues.

MRI revealed a well-defined cortico-medullary digit with typical bone signal, developing near the hypertrophied root of the right corpus cavernosum and the insertion of the right adductor magnus muscle. The CT scan confirmed a pelvic digit with a pseudarthrotic single joint on the ischium. After a thorough 2-step surgical resection, pathologists confirmed the diagnosis. This particular radiologic challenge was to differentiate a pelvic digit from osteochondroma, avulsion-fracture sequelae, ligamentous calcification and myositis ossificans.