What question did this study set out to answer?

This analysis explores how the morphology of the posterior superior iliac spine varies by gender, age, and symmetry in a healthy population.

March 16, 2026Open Access

Is the Morphology of the Posterior Superior Iliac Spine in Chinese Population Related to Gender, Age and Bilateral Symmetry? Insights from Morphometric Analysis Based on CT 3D Reconstruction and Its Clinical Implications

Key Points

This analysis explores how the morphology of the posterior superior iliac spine varies by gender, age, and symmetry in a healthy population.
Retrospective analysis of CT scans from 444 hips (260 males, 184 females) aged 18-80 years.
3D reconstruction of pelvises using Amira-Avizo 3D software to assess morphological characteristics.
Measurements included various dimensions of the PSIS and surrounding pelvic structures.
Four morphological types of PSIS were identified, with significant differences in various parameters (p < 0.05).
Type I PSIS showed the youngest mean age, while Type IV was the oldest, indicating age-related changes (p < 0.05).
Females generally exhibited larger measurements compared to males (p < 0.05).
14% of individuals demonstrated bilateral asymmetry, with Type I/II being the most common pairing.

Abstract

To investigate the morphological characteristics of posterior superior iliac spine (PSIS) in healthy individuals by high-precision three-dimensional (3D) reconstruction. Computed Tomography scans of 444 healthy hips (260 males, 184 females) from patients aged 18-80 years (mean age 36.23 ± 14.03 years) were retrospectively analyzed. 3D pelvises were reconstructed using Amira-Avizo 3D software. Measurements included overall pelvic breadth ( AB ) and height ( CD ), PSIS tip width ( W 0 ), maximum width ( W max ), transition width ( W 5 ), thickness ( H 0 ), distance from PSIS to ischial tuberosity ( AC ), iliac crest apex ( AD ), pubic tubercle ( AE ), iliac tubercle ( AG ), the widest region of posterior iliac crest ( D 0 ) and auricular surface ( AF ). PSIS was categorized into four distinct types: Type I (V-shape, 26.35%), Type II (U-shape, 42.79%), Type III (W-shape, 18.47%), and Type IV (Ossification-shape, 12.39%). Significant difference was found among types, in CD , AC , W 0 , and D 0 ( p 0.05). Sixty-two cases demonstrated bilateral asymmetry with moderate bilateral classification agreement (Cohen’s Kappa=0.574, p < 0.05), of which Type I/II pairing was the most common. Left-right comparisons revealed significant differences in AB , AE , AF , W max , and D 0 parameters ( p < 0.05). The PSIS morphology is highly related to age and gender, alongside considerable bilateral asymmetry, which may be clinically applicable to palpation reliability, surgical planning, rehabilitation programs, and forensic examination. • PSIS morphology is significantly related to age and gender • Females generally exhibit larger dimensional parameters than males across all types • The “Ossification-shape” PSIS morphology is more prevalent in older adults • About 14% of individuals exhibit bilateral asymmetry; Type Ⅰ/Ⅱ pairing most common

Is the Morphology of the Posterior Superior Iliac Spine in Chinese Population Related to Gender, Age and Bilateral Symmetry? Insights from Morphometric Analysis Based on CT 3D Reconstruction and Its Clinical Implications

Key Points

Abstract

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