Osteitis pubis

Case contributed by Stan Buckens
Diagnosis certain

Presentation

Avid recreational football (soccer) player with chronic right-sided adductor tendinopathy.

Patient Data

Age: 25 years
Gender: Male
x-ray

Normal pelvic radiograph. 

mri

Bone marrow edema around the symphysis pubis congruent with osteitis pubis. High signal intensity in the adductor attachments on the right side of the symphysis are in keeping with the symptoms of adductor tendinopathy. 

Case Discussion

Inflammation of the pubic symphsis and adjacent structure (termed osteitis pubis) can arise in athletes in and about the pubic symphsis, especially in those engaged in sprinting, kicking, twisting and cutting, such as football players. 

Inflammatory changes in and about the pubic symphysis may also arise after massive urologic/gynecologic operations or pregnancy, osteomyelitis, in the context of rheumatologic diseases, as well as in athletes, as here. 

This football (soccer) player presented with adductor tendinopathy and reduced hip exorotation in his dominant leg. This case shows florid bone marrow edema but findings underlying debilitating pain in athletes may be much more subtle, e.g. showing only tendinopathy without bone marrow edema. 

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