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<v ->We're gonna move on now

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and I'm gonna illustrate over the next 15 minutes or so

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some other areas that we see plica or synovial folds.

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So intraarticular synovial folds,

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which have been called retinacula or plica

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are certainly seen in the hip.

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And they are not pathologic in most of these cases,

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in fact, one of them,

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known as the medial synovial fold,

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is a vascular fold, often called a fold of Amantini,

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that is necessary in order to supply blood supply

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to the femoral head.

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So you've all seen that particular synovial fold,

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this is what it looks like, it's classic.

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Do not call it a thickened plica and take it out,

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because it's carrying blood to the femoral head,

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that's one of the main sources of blood to the femoral head.

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There's another area in the hip joint

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that also is kind of interesting,

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It goes by the name of a Stellate Crease.

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I'm not sure how many you listening to me right now

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have ever heard of the Stellate Crease,

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but it's a bare area on the acetabular side,

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deficient inarticulate cartilage, okay,

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near the acetabular fossa.

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Here is one example,

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this one taken from the literature

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to show you what it looks like.

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And it looks like an area that has no cartilage,

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and so if you're not aware of this normal variant

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you may start talking about a chondral defect

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or an osteochondral injury,

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but this is a normal variant,

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and it is very, very frequent.

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There is a lesion now however,

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that occurs here that consists of a plica

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and we came across one in a histologic study

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that we were doing of the hip joint,

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and there's the pictures that we got from our histology,

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and you can see this one is a small fibrous fold,

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I have no idea, this is a cadaver,

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whether or not this was symptomatic,

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I doubt it, but you can see the histology,

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it's not fat, it's fibrous tissue.

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You can see what it looks like

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on their morphology of our gross specimen.

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And there are reports of this occurring

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in this region, the Stellate Crease,

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and it goes by the name of the Stellate Lesion.

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Here's another one.

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This patient did have clicking and pain in the hip,

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we never could prove that this was the cause of it,

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but you can appreciate, again,

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a fibrous area in the region of the acetabular fossa

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looking like a plica.