Pubic apophysitis – an important cause of groin pain in young athletes

IF 11.6 1区 医学 Q1 SPORT SCIENCES British Journal of Sports Medicine Pub Date : 2024-09-09 DOI:10.1136/bjsports-2024-108710
David F Hanff, Astrid van Ovost, Bruce B Forster, Adam Weir
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Abstract

A 17-year-old male right-footed footballer presented with a 6-month history of left-sided groin pain which was persistent despite resting for 6 weeks. Pain occurred during running and daily activities including climbing the stairs and turning over in bed. On examination, the cardinal findings were tenderness of the pubic bone near the adductor insertion on the left side and pubic pain during resisted adduction. An initial pelvic radiograph was suboptimal due to overlying bowel gas but did show minor cortical irregularities (arrow, figure 1A) and features of an immature pubic symphysis including non-fused apophysis on the inferior side of the pubic symphysis and lower region joint lines are not yet fully ossified. MRI examination showed features, together with the clinical findings, that are typical for pubic apophysitis. There was bilateral extensive bone marrow oedema of the whole part shown of the pubic symphysis (arrow, figure 1B) on the coronal fat-suppressed sequence. A more focal high fluid signal along the left apophysis was also seen (arrow, figure 1C). Cortical irregularity on the left side with cystic and erosion-like configurations and widening of the pubic symphysis …
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耻骨远端骨膜炎--年轻运动员腹股沟疼痛的一个重要原因
一名 17 岁的右脚男足球运动员因左侧腹股沟疼痛就诊 6 个月,休息 6 周后疼痛仍持续存在。疼痛发生在跑步和日常活动中,包括爬楼梯和在床上翻身。检查的主要发现是左侧内收肌插入处附近的耻骨有触痛感,以及在用力外展时耻骨疼痛。最初的骨盆X光片因覆盖肠道气体而不理想,但确实显示出轻微的皮质不规则(箭头,图1A)和耻骨联合不成熟的特征,包括耻骨联合下侧未融合的骨骺和尚未完全骨化的下部关节线。核磁共振检查显示,结合临床表现,该病具有耻骨干炎的典型特征。在冠状脂肪抑制序列上,耻骨联合的整个部分出现了双侧广泛的骨髓水肿(箭头,图 1B)。沿左侧干骺端还可见一个更局灶性的高液体信号(箭头,图 1C)。左侧皮质不规则,呈囊状和糜烂状,耻骨联合增宽。
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来源期刊
CiteScore
27.10
自引率
4.90%
发文量
217
审稿时长
3-8 weeks
期刊介绍: The British Journal of Sports Medicine (BJSM) is a dynamic platform that presents groundbreaking research, thought-provoking reviews, and meaningful discussions on sport and exercise medicine. Our focus encompasses various clinically-relevant aspects such as physiotherapy, physical therapy, and rehabilitation. With an aim to foster innovation, education, and knowledge translation, we strive to bridge the gap between research and practical implementation in the field. Our multi-media approach, including web, print, video, and audio resources, along with our active presence on social media, connects a global community of healthcare professionals dedicated to treating active individuals.
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