15.14 Conclusion
Medical imaging has an extremely valuable role in the differentiation between the wide range of potential causes of hip and groin pain in athletes. Without such differentiation effective treatment is difficult to achieve especially where considering overuse injuries which may even be exacerbated by treatment based on diagnostic inaccuracy.
Understanding the anatomy of the anterior pubic soft tissues allows correlation with MR imaging pathoanatomical appearances and therefore a better understanding of the pathomechanism of groin pain in athletes on which to base subsequent treatment.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Ackerman N, Spencer CP (1992) What is your diagnosis? Prepubic tendon injury, with avulsion fracture of the left pubis. J Am Vet Med Assoc 200(5):721–722
Adams RJ, Chandler FA (1953) Osteitis pubis of traumatic etiology. J Bone Joint Surg (Am) 35(3):685–696
Akermark C, Johansson C (1992) Tenotomy of the adductor longus tendon in the treatment of chronic groin pain in athletes. Am J Sports Med 20:640–643
Akita K, Niga S, Yamato Y et al. (1999) Anatomic basis of chronic groin pain with special reference to sports hernia. Surg Radiol Anat 21(1):1–5
Albers SL, Spritzer CE, Garrett WE Jr et al. (2001) MR findings in athletes with pubalgia. Skeletal Radiol 30(5):270–277
Albert M (1983) Descriptive Three Year Data Study of Outdoor and Indoor Professional Soccer Injuries. Athletic Train; 18:218–220
Ashby EC (1994) Chronic obscure groin pain is commonly caused by enthesopathy-“tennis elbow” of the groin. Br J Surg 81:1632–1634
Bouza E, Winston DJ, Hewitt WL (1978) Infectious osteitis pubis. Urology 12:663–669
Bradshaw C, McCrory P, Bell S et al. (1997) Obturator nerve entrapment. A cause of groin pain in athletes. Am J Sports Med 25(3):402–408
Breitenfelder J, Huke B, Wolf N (1975) The problem of stress of the symphysis following hip arthrodesis (German). Archiv Orthopad Unfall-Chirurgie 81(2):119–124
Budinoff LC, Tague RG (1990). Anatomical and developmental bases for the ventral arc of the human pubis. Am J Phys Anthropol 82(1):73–79
Carnevale V (1954) La Denominada ‘Inguiocruralgia Traumatic de los Jugadores de Futbol’. Prensa Med Argent 41(5):355–357
Casey D, Mirra J, Staple TW (1984) Parasymphyseal insufficiency fractures of the os pubis. Am J Roentgenol 142:581–586
Cochrane GM (1971) Osteitis pubis in athletes. Br J Sports Med 5:233–235
Dalstra M, Huiskes R, Odgaards A et al. (1993) Mechanical and textural properties of pelvic trabecular bone. J Biomech 26:523–535
Ekberg O, Persson NH, Abrahamsson PA et al. (1988) Longstanding groin pain in athletes. A multidisciplinary approach. Sports Med 6:56–61
Ekstrand J, Gillquist J (1983) The avoidability of soccer injuries. Int J Sports Med 4:124–128
Evans TW, Eveley RS, Morcos SK (1985) Asymptomatic osteomyelitis of the symphysis pubis. Postgrad Med J 61:267–268
Fink-Bennett DM, Benson MT (1984) Unusual exercise related stress fractures — two case reports. Clin Nucl Med 9:430–434
Fredberg U, Kissmeyer-Nielsen P (1996) The sportsman’s hernia-fact or fiction? Scand J Med Sci Sports 6:201–204
Fricker PA, Taunton JE, Ammann W (1991) Osteitis pubis in athletes. Infection, inflammation or injury? Sports Med 12(4):266–279
Gibbon WW (1998) Are Achilles tendon ruptures ever spontaneous? Br J Sports Med 32(3):266
Gibbon WW, Cooper JR, Radcliffe GS (1999) Sonographic incidence of tendon microtears in athletes with chronic Achilles tendinosis. Br J Sports Med 33(2):129–130
Gibbon WW, Cooper JR, Radcliffe GS (2000) Distribution of sonographically detected tendon abnormalities in patients with a clinical diagnosis of chronic Achilles tendinosis. J Clin Ultrasound 28(2):61–66
Gilmore OJA (1993) “Gilmore’s groin”: a previously unsolved problem in sportsmen. In: Mcleod DA, Maughan RJ, Williams C, Madeley CR, Sharp JMC, Nutton RW et al. (eds) Intermittent high intensity exercise; preparation, stresses and damage limitation. Chapman and Hall, London, pp 477–486
Goergen TG, Resnick D, Riley RR (1978) Post-traumatic abnormalities of the pubic bone simulating malignancy. Radiology 126(1):85–87
Gregory WK (1950) The anatomy of the gorilla; Henry Cushior Memorial Volume. Gregory WK (ed) New York, Columbia University Press, pp 150–151
Hackney RG (1993) The sports hernia: a cause of chronic groin pain. Br J Sports Med 27:58–62
Harris NH, Murray RO (1974) Lesions of the symphysis in athletes. Br Med J 4:211–214
Heldrich F, Harris V (1979) Osteomyelitis of the pubis. Acta Paediatr Scand 68:39–41
Holmich P, Uhrskou P, Ulnits L et al. (1999) Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. Lancet 6;353:439–443
Holt MA, Keene JS, Graf BK et al. (1995) Treatment of osteitis pubis in athletes. Results of corticosteroid injections. Am J Sports Med 23(5):601–606
Hoon JR (1959) Adductor muscle injuries in bowlers. JAMA 171:2087–2089
Hornof Z, Napravnik C (1969) Analysis of various accident rate factors in ice hockey. Med Sci Sports 5:283–286
Irshad K, Feldman LS, Lavoie C et al. (2001) Operative management of “hockey groin syndrome”: 12 years of experience in National Hockey League players. Surgery 130(4):759–764
Jajic Z, Jajic I (1998) Condensing osteitis of the pubic bone. Reumatizam 46(1):51–53
Kassarjian A, Yoon LS, Belzile E et al. (2005) Triad of MR arthrographic findings in patients with cam-type femoro-acetabular impingement. Radiology 236:588–592
Keller CS, Noyes FR, Buncher CR (1987) The medical aspects of soccer injury epidemiology. Am J Sports Med 15(3):105–112
Koch RA, Jackson DW (1981) Pubic symphysitis in runners-a report of two cases. Am J Sports Med 8(1):62–63
Lebrun C, Vanhoenacker FM, Willemen D (2005) Anterior femoro-acetabular impingement of the CAM type. Radiological documents (2):15
Lee CH, Dellon AL (2000) Surgical, anagement of groin pain of neural origin. J Am Coll Surg 191(2):137–142
Leno C, Combarros O, Polo JM et al. (1984) Bilateral obturator neuralgia secondary to osteitis of the pubis. Arch Neurobiol (Madr) 47(6):347–352
Losada A, Saldias E (1968) Osteopatia dinamica del pubis. Revista Med 96:110–113
Lovell G (1995) The diagnosis of chronic groin pain in athletes: a review of 189 cases. Aust J Sci Med Sport 27(3):76–79
Marsden AJ (1962) Inguinal hernia: a three year review of two thousand cases. Br J Surg 49:384–394
Martens MA, Hansen L, Mulier JC (1987) Adductor tendinitis and musculus rectus abdominis tendopathy. Am J Sports Med 15:353–356
McGonagle D, Gibbon W, O’Connor P et al. (1998) Characteristic magnetic resonance imaging entheseal changes of knee synovitis in spondylarthropathy. Arthritis Rheum 41(4):694–700
Mitchell B, McCrory P, Brukner P et al. (2003) Hip joint pathology: clinical presentation and correlation between magnetic resonance arthrography, ultrasound, and arthroscopic findings in 25 consecutive cases. Clin J Sport Med 13(3):152–156
Modic MT, Steinberg PM, Ross JS et al. (1988) Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 166(1):193–199
Morcuende JA, Arauz S, Weinstein SL (2000) Stress fracture of the hip and pubic rami after fusion to the sacrum in an adult with scoliosis: a case report. Iowa Orthop J 20:79–84
Moretz A, Rashkin A, Grana WA (1978) Oklahoma high school football injury study: a preliminary report. J Okla State Med Assoc 71:85–86
Nicholas JJ, Haidet E, Helfrich D et al. (1989) Groin and hip pain due to fractures at or near the pubic symphysis. Arch Phys Med Rehabil 70(9):696–698
Nielsen AB, Yde J (1989) Epidemiology and traumatology of injuries in soccer. Am J Sports Med 17(6):803–807
Numaguchi Y (1971) Osteitis condensans ilii, including its resolution. Radiology 98:1
Ogden JA (1980). Chondro-osseous development and growth. In: Urist MR (ed) Fundamental and clinical bone physiology. JB Lippincott Company, Philadelphia, pp 108–171
Orava S, Puranen J, Ala-Ketola L (1978). Stress fractures caused by physical exercise. Acta Orthop Scand 49:19–27
Patterson FP, Yovanovich R (1975) Pubic osteomyelitis and septic arthritis of the symphysis pubis. In: Proceedings of the Canadian Orthopaedic Association. J Bone Joint Surg (Br) 57(4):531–532
Pierson EL (1929) Osteochondritis of the symphysis pubis. Surg Gynecol Obstet 49:834–838
Reideberger Von J, Luschnitz E, Bauchspeiss (1967) The pubic adductor syndrome in footballers. Zentralblatt Chirugie 92:2655–2657
Rosenklint A, Anderson RB (1969) Tenosteochondrosis of the pubis. Acta Rheum Scand 15:262–270
Rosenthal RE, Spickard WA, Markham RD et al. (1982) Osteomyelitis of the symphysis pubis: a separate disease from osteitis pubis. J Bone Joint Surg (Am) 64(1):123–128
Saw T, Villar R (2004) Footballer’s hip: a report of six cases. J Bone Joint Surg (Br) 86(5):655–658
Schneider PG (1963) Das Grazilissyndrom. Z Orthop 93:43–46
Seward H, Orchard J, Hazard H, Collinson D et al. (1993) Football injuries in Australia at the elite level. Med J Aust 159:298–301
Sexton DJ, Keskestad L, Lambeth WR et al. (1993) Postoperative pubic osteomyelitis misdiagnosed as osteitis pubis: report of four cases and review. Clin Infect Dis 17(4):695–700
Spinelli A (1932) Nuova Malattia Sportive: La Pubialgia Degli Schernitori. Ortopedia E Trauma Apparato Motore 4:111–127
FIFA (1992) Statistics on the 186 Affiliated National Associations of FIFA, FIFA, Zurich, Switzerland
Sturesson B, Selvik G, Uden A (1989) Movements of the sacroiliac joints. A Roentgen stereophotogrammetric analysis. Spine 14(2):162–165
Tan AL, Marzo-Ortega H, O’Connor P et al. (2004) Efficacy of anakinra in active ankylosing spondylitis: a clinical and magnetic resonance imaging study. Ann Rheum Dis 63(9):1041–1045
Walheim GG, Selvik G (1984) Mobility of the pubic symphysis-in vivo measurements with an electromechanic method and a Roentgen stereophotogrammetric method. Clin Orthop 191:129–135
Weaver CJ, Major NM, Garrett WE et al. (2002) Femoral head osteochondral lesions in painful hips of athletes: MR imaging findings. Am J Roentgenol 178(4):973–977
Wiley JJ (1983) Traumatic osteitis pubis: the Gracilis syndrome. Am J Sports Med 11(5):360–363
Williams JGP (1978) Limitation of hip joint movement as a factor of traumatic osteitis pubis. Br J Sports Med 12(3):129–133
Ziprin P, Williams P, Foster ME (1999) External oblique aponeurosis nerve entrapment as a cause of groin pain in the athlete. Br J Surg 86(4):566–568
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2007 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Gibbon, W., Schilders, E. (2007). Pelvis, Hip and Groin. In: Vanhoenacker, F.M., Maas, M., Gielen, J.L. (eds) Imaging of Orthopedic Sports Injuries. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68201-1_15
Download citation
DOI: https://doi.org/10.1007/978-3-540-68201-1_15
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-26014-1
Online ISBN: 978-3-540-68201-1
eBook Packages: MedicineMedicine (R0)