Grading Scale of Radiographic Findings in the Pubic Bone and Symphysis in Athletes

Abstract

Grading scale of radiographic findings in the pubic bone and symphysis in athletes.Besjakov, Jack; von Scheele, C; Ekberg, Olle; Gentz, C F; Westlin, N E Published in: Acta Radiologica DOI: 10.1034/j. 1600 -0455.2003 .00010.x Published: 2003 Link to publication Citation for published version (APA): Besjakov, J., von Scheele, C., Ekberg, O., Gentz, C. F., & Westlin, N. E. (2003). Grading scale of radiographic findings in the pubic bone and symphysis in athletes. Acta Radiologica, 44(1), 79-83. DOI: 10.103479-83. DOI: 10. /j.160079-83. DOI: 10. -0455.2003 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. AbstractPurpose: Radiographic abnormalities in the pubic bone and symphysis are often seen in athletes with groin pain. The aim was to create a grading scale of such radiologic changes.Material and Methods: Plain radiography of the pelvic ring including the pubic bone and the symphysis was performed in 20 male athletes, age 19-35, with long-standing uni-or bilateral groin pain. We used two control groups: Control group 1: 20 healthy age-matched men who had undergone radiologic examination of the pelvis due to trauma. Control group 2: 120 adults (66 men and 54 women) in 9 age groups between 15 and 90 years of age. These examinations were also evaluated for interobserver variance.Results and Conclusion: The grading scale was based on the type and the amount of the different changes, which were classified as follows: No bone changes (grade 0), slight bone changes (grade 1), intermediate changes (grade 2), and advanced changes (grade 3). The grading scale is easy to interpret and an otherwise troublesome communication between the radiologist and the physician was avoided. There was a high interobserver agreement with a high kappa value (0.8707). Male athletes with long-standing groin pain had abnormal bone changes in the symphysis significantly more frequently and more severely (p>0.001) than their age-matched references. In asymptomatic individuals such abnormalities increased in frequency with age both in men and women.

Radiological findings in symphyseal and adductor-related groin pain in athletes: a critical review of the literature

“…There was a total of six MRI case–control studies,12 14 16 17 19 20 of which one had two control groups12 and five had one control group 14 16 17 19 20. Three radiographic studies had one21 25 or two26 control groups. In the US study,23 patients in the case-study group functioned as their own controls, as their symptomatic and asymptomatic sides were compared with each other.…”

The effect of factors other than age upon skeletal age indicators in the adult

“…Soft tissue lesions include posterior herniation of the symphysial disc, periarticular oedema and tearing of the disc and periarticular entheses. Bone alterations include erosion of the subchondral bone, leaving an irregular symphysial surface, sclerosis, cyst formation and, less often, periarticular osteophytes (Besjakov et al, 2003;Budak & Oliver, 2013;Cunningham et al, 2007;Major & Helms, 1997;Mehin et al, 2006). The bony alterations resemble both sequelae from parturition trauma (Putschar, 1976;Vix & Ryu, 1971;Wurdinger et al, 2002) and gross features of later phases described in ageing schemata.…”

Management of chronic recurrent osteitis pubis/pubic bone stress in a Premier League footballer: Evaluating the evidence base and application of a nine-point management strategy

“…The patient also demonstrated surface irregularity (R > L) consistent with chronic PBS (Cunningham et al, 2007;Robinson et al, 2004). Clinically (Rodriguez et al, 2001) (Table 1) and radiologically (Besjakov, von Scheele, Ekberg, Gentz, & Westlin, 2003;Cunningham et al, 2007;Robinson et al, 2004;Verrall, Slavotinek, et al, 2005) (Fig. 1) he presented with moderatesevere pubic bone stress, although the existing terminology and grading requires more rigid definition (Branci, Thorborg, Bachmann Nielsen, & Holmich, 2013).…”