Pediatric Radiology

, Volume 35, Issue 10, pp 995–997 | Cite as

Iliac hyperdense line: a new radiographic sign of gluteal muscle contracture

  • Jin-Hua Cai
  • Lan-Feng Gan
  • He-Lin Zheng
  • Hao Li
Original Article


Background: A hyperdense line on the ilium that runs roughly parallel to the sacroiliac joint (we called it “iliac hyperdense line sign”) was frequently observed on pelvic radiographs of patients with gluteal muscle contracture (GMC). A literature search revealed no description of this sign. Objective: To determine the relationship between the iliac hyperdense line sign and GMC and to explore how this sign is formed. Materials and methods: Pelvic plain films of 103 cases of GMC and those of 200 control individuals were reviewed for the presence or absence of the iliac hyperdense line sign. Pelvic CT scans in 8 of 103 cases and 13 of 200 controls were analyzed with relation to the plain films. Results: The iliac hyperdense line sign was visualized in 85 of 103 (82.5%) cases of GMC and none of the 200 controls. In the GMC group, pelvic CT scans showed a deformity of the posterior ilium. The lateral cortex of the posterior ilium took on a partly or completely anteroposterior course, while in the control group the course appeared as an oblique orientation from posteromedial to anterolateral. Conclusion: The iliac hyperdense line on pelvic plain film can be used as a radiographic sign to suggest a diagnosis of GMC. This sign might be a result of the long and persistent pulling effect of the contracted gluteus maximus muscle, which deforms the lateral cortex of the posterior ilium from an oblique course to an anteroposterior course tangential to the X-ray beam.


Gluteal muscle contracture Pelvis Radiography CT 


  1. 1.
    Lejman T, Sulko J, Michno P (1995) Surgical treatment of post injection contracture of the hip in children. Chir Narzadow Ruchu Ortop Pol 60:39–41PubMedGoogle Scholar
  2. 2.
    Liu G, Du J, Yang S, et al (2000) A retrospective analysis of the gluteal muscles contracture and discussion of the relative problems. J Tongji Med Univ 20:70–71PubMedGoogle Scholar
  3. 3.
    Chen SS, Chien CH, Yu HS (1988) Syndrome of deltoid and/or gluteal fibrotic contracture: an injection myopathy. Acta Neurol Scand 78:167–176PubMedGoogle Scholar
  4. 4.
    Chung DC, Ko YC, Pai HH (1989) A study on the prevalence and risk factors of muscular fibrotic contracture in Jia-Dong Township, Pingtung county, Taiwan. Gaoxiong Yi Xue Ke Xue Za Zhi 5:91–95PubMedGoogle Scholar
  5. 5.
    Sun X (1990) An investigation on injectional gluteal muscle contracture in childhood in Mianyang city. Zhonghua Liu Xing Bing Xue Za Zhi 11:291–294PubMedGoogle Scholar
  6. 6.
    Gao GX, Zheng YY (1985) Idiopathic contracture of the M gluteus maximus in children. Chin Med J (Engl) 98:803–806Google Scholar
  7. 7.
    Napiontek M, Ruszkowski K (1993) Paralytic drop foot and gluteal fibrosis after intramuscular injections. J Bone Joint Surg Br 75:83–85PubMedGoogle Scholar
  8. 8.
    Hang YS (1979) Contracture of the hip secondary to fibrosis of the gluteus maximus muscle. J Bone Joint Surg Am 61:52–55PubMedGoogle Scholar
  9. 9.
    Bowen JR, MacEven GD, Mathews PA (1981) Treatment of extension contracture of the hip in cerebral palsy. Dev Med Child Neurol 23:23–29PubMedGoogle Scholar
  10. 10.
    Shen YS (1975) Abduction contracture of the hip in children. J Bone Joint Surg Br 57:463–465PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Jin-Hua Cai
    • 1
  • Lan-Feng Gan
    • 1
  • He-Lin Zheng
    • 1
  • Hao Li
    • 1
  1. 1.Department of Radiology, Children’s HospitalChongqing Medical UniversityChongqingChina

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