What causes Mickey Mouse pelvis on pelvic radiographs?
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Answer: The Mickey Mouse pelvis sign on pelvic radiographs results from abnormal iliac wing morphology characterized by small, squared iliac wings with a flattened appearance and increased acetabular angles. This radiographic finding is typically seen in skeletal dysplasias such as achondroplasia, reflecting underlying abnormal endochondral ossification and pelvic remodeling. The Mickey Mouse pelvis appearance is commonly associated with conditions causing disproportionate dwarfism and pelvic skeletal dysplasia.
Why is it called so?
The term Mickey Mouse pelvis arises from the visual resemblance of the bilateral small, squared iliac wings to Mickey Mouse ears on pelvic radiographs, with the pelvic inlet resembling the face and the iliac wings like the ears.
Pathophysiology
The sign develops due to defective endochondral ossification in the iliac wings, causing them to appear hypoplastic and squared rather than the normal broad, flared shape. The resultant altered pelvic anatomy leads to flattening of iliac blades and increased acetabular angles, producing the characteristic shape on imaging.
Alternative names: Tombstone iliac wings, Mickey Mouse ears pelvis
Other associated named signs: Trident sign (seen in achondroplasia), Champagne glass pelvis (reflecting narrowed pelvic inlet with flattened iliac wings)
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