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Iliopubic eminence

The iliopubic eminence (eminentia iliopubica) is a bony prominence on the pelvic brim, located at the junction of the iliopectineal line of the ilium and the superior pubic ramus. It is situated anteromedial to the acetabulum, forming part of the true pelvic inlet.

This landmark represents the transition between the ilium and pubis and serves as an important radiographic and surgical marker. On pelvic radiographs, the iliopubic eminence helps define the iliopectineal line, which is used to assess acetabular fractures, hip dysplasia, and pelvic alignment.

The psoas minor tendon, when present, inserts at the iliopubic eminence. It also provides fascial anchoring for the iliac fascia and contributes to the structural continuity of the anterior pelvic brim.

Clinically, the iliopubic eminence is an important marker in orthopedic surgery (periacetabular osteotomy, pelvic fracture fixation) and in imaging assessment of acetabular and pelvic injuries.

Synonyms

  • Eminentia iliopubica

  • Iliopubic eminence of the pelvis

  • Iliopubic protuberance

Function

  • Serves as the junctional landmark between ilium and pubis

  • Provides attachment for the psoas minor tendon (when present)

  • Serves as an anchoring point for the iliac fascia

  • Acts as a radiological landmark for assessing pelvic and acetabular integrity

Nerve Supply (related structures)

  • Psoas minor (if present) is innervated by the L1 ventral ramus

Arterial Supply

  • Branches from the obturator artery

  • Contributions from the inferior epigastric artery and medial circumflex femoral artery

Venous Drainage

  • Corresponding venous drainage via the obturator vein and pelvic venous plexuses

MRI Appearance

T1-weighted images:

  • Bone cortex: hypointense (dark rim)

  • Marrow: intermediate signal

  • Surrounding soft tissue attachments visible with moderate signal

T2-weighted images:

  • Bone cortex: hypointense

  • Bone marrow: intermediate to bright, depending on fat content

  • Detects marrow edema in trauma or overuse injury

PD Fat-Saturated (Proton Density FS):

  • Bone cortex: remains dark

  • Marrow edema, enthesopathy, or stress reaction: hyperintense

  • Sensitive for insertional pathology of psoas minor or iliac fascia

STIR:

  • Highlights bone marrow edema, fractures, and inflammatory changes

  • Useful for early detection of pelvic stress injuries

T1 Post-Gadolinium (fat-saturated):

  • Normal bone cortex: does not enhance

  • Inflammation, tumor, or infection: shows abnormal enhancement

  • Helpful for osteitis pubis vs. neoplastic infiltration differentiation

3D T2-weighted Imaging:

  • Provides isotropic imaging for multiplanar reconstruction of pelvic brim and acetabulum

  • Highlights iliopubic eminence morphology for surgical planning (osteotomies, fracture fixation)

CT Appearance

Non-contrast CT:

  • Bone cortex: hyperdense, clearly defined

  • Marrow: hypodense compared to cortex

  • Excellent for fracture evaluation, cortical irregularity, and bony remodeling

CT Post-Contrast:

  • Bone cortex: unchanged

  • Soft tissues: enhancement highlights inflammatory or neoplastic pathology adjacent to the eminence

  • Used for preoperative evaluation of pelvic tumors or infection

Clinical Significance

  • Pelvic fractures: Iliopubic eminence disruption seen in acetabular or pubic fractures.

  • Hip dysplasia & osteotomies: Landmark for periacetabular osteotomy surgical cuts.

  • Sports injuries: May show marrow edema or stress reactions in overuse athletes.

  • Radiographic landmark: Part of the iliopectineal line, key in acetabular fracture classification.

CT VRT 3D image

Iliopubic eminence 3D CT VRT anatomy image

CT image

Iliopubic eminence ct axial image

MRI image

Iliopubic eminence MRI axial anatomy image-img-00000-00000