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Romanian Society for Sports Medicine



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"Medicina Sportiva" No.14 - 2008 The 15-th Sports Medicine Balkan Congress
INJURIES IN SPORTS


MR IMAGING OF OSTEITIS PUBIS IN ATHLETES

Bolog N1, Mangrau Angelica1, Oancea Irinel 1, Banicescu Antonia 1, Andreisek G2
1 Phoenix Diagnostic Clinic, Bucharest, Romania, 2 University Hospital Zurich, Switzerland


Osteitis pubis is an inflammatory process of the symphysis pubis. Spinelli first described this entity in athletes in 1932. Osteitis pubis involves the athletes participating in football, rugby, tennis, and ice hockey. This condition is frequently associated with recurrent stretching and tearing of the stabilizing anterior ligaments and adductor muscles. Pathologically, the articular surface is irregular, with sclerosis, erosions and osteophytes. the fibrocartilaginous disk is degenerated and herniation of the disk is a frequent finding. Microtears of the adductor attachments occur especially in football players. The athletes present pain in the adductor muscles, in the symphysis pubis and lower abdominal muscles.  Pubalgia is responsible for 2-5% of all sports injuries. The condition has an important effect on the competitive performance of the athletes as well as on the economical situation of the sporting organizations. The diagnosis is usually delayed because of the non-specific clinical findings. The final diagnosis is based on the physical examination combined with different imaging modalities. Radiography, ultrasound, bone scan and MR imaging are used for the evaluation of these patients. Although, the clinical examination is still considered the standard of reference for diagnosis, MR imaging is the imaging method of choice in evaluation of osteitis pubis.  MRI enables to detect the presence of bone marrow edema of the articular surfaces together with the disk pathological changes (e.g. degeneration, herniation). Moreover, MRI is capable to asses both muscular changing and attachments tears. A correct and early diagnosis is of utmost importance in athletes with pubalgia since the return of the athletes in competition highly depends on the treatment and management of this condition.





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