INJURIES
IN SPORTSMR
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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