Groin Injuries and Groin Pain in Athletes: Part 2
Section snippets
Disorders of the os pubis
Osteitis pubis, or inflammation of the symphysis pubis, is seen commonly in runners [1], hockey players [2], and soccer players. In this condition, shearing forces across the pubic symphysis may result in symphysis inflammation or even joint disruption [3]. Repetitive adductor pull on the symphysis has also been proposed as one of the etiologic mechanisms [2]. Cutting and twisting forces may transmit even greater forces to the pubic symphysis in athletes lacking ideal ranges of hip flexibility
Osteomylitis of the pubic symphysis
Another condition that must be kept in the differential diagnosis of osteitis pubis is osteomyelitis, or bacterial infection of the pubic symphysis or adjacent bone. This condition is usually seen following surgical procedures in the area, but has also been seen after childbirth [18], and has been reported to occur spontaneously in athletes [19], [20], [21]. A recent review of 100 cases reported that 24% of cases occurred after female incontinence surgery, 19% occurred spontaneously in
Stress fractures
The two most common stress fractures of the groin region are femoral neck stress fractures and pubic ramus fractures. They are caused by repetitive overuse and overload, and are usually seen in distance runners or military recruits. Additional risk factors include relative osteoporosis in young female athletes who have nutritional or hormonal imbalances, muscle fatigue (which may reduce shock-absorbing abilities), changes in foot gear or training surface, and sudden increases in intensity or
Disorders of the hip
When evaluating groin pain in the athlete, the physician must remember that hip pathology can refer pain to the groin region. Acetabular labral tears, articular cartilage defects of the femoral head or acetabulum, loose bodies, capsular laxity, and injuries to the ligamentum teres all may present as groin pain. Other less common presenting conditions include osteonecrosis of the femoral head, slipped capital femoral epiphysis, gout, pseudogout, synovial chondromatosis, and infection [30].
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Cited by (37)
MRI in patients with chronic pubalgia: Is precise useful information provided to the surgeon? A case control study
2016, Revue de Chirurgie Orthopedique et TraumatologiqueMRI in patients with chronic pubalgia: Is precise useful information provided to the surgeon? A case-control study
2016, Orthopaedics and Traumatology: Surgery and ResearchCitation Excerpt :AP is a relatively common occurrence and has been attributed to one of three broad etiological categories: AL lesion, osteitis pubis, parietal lesion [16]. As treatment plans have diverged in recent years on the basis of the specific structures involved, it is now necessary for the clinician to accurately localize the injury and determine its severity and extent [17,18]. Many studies assessed and described good accuracy for MR imaging in AP, in contrast for the majority of series, physical examination findings remained the reference standard with high prevalence of MRI abnormalities in asymptomatic patients [12,19].
Imaging features of pubalgia
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