Osteitis pubis in professional football players: MRI findings and correlation with clinical outcome

Gaudino, F; Spira, Daniel; Bangert, Yannic; Ott, H.; Zobel, Bruno Beomonte; Kauczor, Hans‐Ulrich; Weber, Marc‐André

doi:10.1016/j.ejrad.2017.07.009

Cited by 23 publications

(16 citation statements)

References 25 publications

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“…Radiographical findings at the symphysis are often observed as reactive sclerosis at the pubic symphysis 13 21. A recent 18-month follow-up trial reported that extensive BME on STIR sequences may predict a poor clinical outcome, that is, the athletes with extensive BME recovered less likely to high-level sports activity 22. In contrast to this, we found that BME was as common in symptomatic as in asymptomatic players.…”

Section: Discussioncontrasting

confidence: 92%

Long-standing groin pain in contact sports: a prospective case–control and MRI study

Paajanen

Hermunen

Ristolainen

et al. 2019

BMJ Open Sport Exerc Med

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ObjectivesWe aimed to prospectively evaluate the prevalence of long-standing groin pain and related MRI findings in contact sports.MethodsThis case–control study followed three male elite-level soccer, ice-hockey and bandy teams (102 players) for 2 years. All athletes with long-standing groin pain lasting >30 days and age-matched controls (1:3) from the same teams were examined clinically, using pelvic MRI and Hip and Groin Outcome Scores (HAGOS). Primary outcome measures were annual prevalence of groin pain and underlying MRI findings.ResultsThe annual prevalence of chronic groin pain was 7.5%. Training characteristics and pain scores of athletes were similar in all teams. On MRI, there was no significant difference in the percentage of pubic bone marrow oedema (p = 0.80) between symptomatic players (8/15; 53%) versus controls (20/43; 47%), but adductor tendinopathy and degenerative changes at the pubic symphysis were twice more common among players with pain. Rectus muscle or iliopsoas pathology were seldom observed. Lower HAGOS subscales (p < 0.01) were recorded in players who experienced groin pain compared with the controls.ConclusionLong-standing groin pain was observed annually in 1 of 14 athletes in contact sports. Abnormalities in the pubic symphysis were common MRI findings in both symptomatic and asymptomatic players.Trial registration numberNCT02560480

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Section: Discussioncontrasting

confidence: 92%

Long-standing groin pain in contact sports: a prospective case–control and MRI study

Paajanen

Hermunen

Ristolainen

et al. 2019

BMJ Open Sport Exerc Med

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“…18,24 MRI scans were reviewed for marrow edema in the subarticular pubic bone indicating acute changes and for subchondral sclerosis, cysts, joint surface erosions, and ankylosis indicating more chronic joint abnormality. 5,9,22 All radiographic analysis was performed by a fellowship-trained orthopaedic surgeon (V.P.K. ), who did not perform the hip arthroscopy procedures.…”

Section: Radiographic Analysismentioning

confidence: 99%

“…23 The American Journal of Sports Medicine 2019;47 (6):1467-1472 DOI: 10.1177/0363546519837203 Ó 2019 The Author(s) Magnetic resonance imaging (MRI) has been used previously to identify abnormalities in the SP in athletes with groin pain and clinical diagnosis of osteitis pubis. 5 The combined use of fat-suppressed fluid-sensitive sequences (T2/ Short Tau Inversion Recovery [STIR]) and non-fat suppressed T1-weighted sequences is recommended. Other studies have reported that subchondral sclerosis, subchondral resorption, bony margin irregularities, and osteophytes are the most reliable MRI findings of chronic osteitis pubis and have a high sensitivity of discriminating acute from chronic changes in the SP.…”

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confidence: 99%

Radiographic Prevalence of Symphysis Pubis Abnormalities and Clinical Outcomes in Patients With Femoroacetabular Impingement Syndrome

et al. 2019

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Background: The decreased hip range of motion seen in femoroacetabular impingement syndrome (FAIS) may lead to compensatory increased motion at the symphysis pubis (SP) with resultant increased stress on the joint, which can subsequently lead to osteitis pubis. Purpose: To quantify the prevalence of SP abnormalities in patients with FAIS through the use of imaging modalities and to compare outcomes based on the presence of SP abnormalities. Study Design: Cohort study; Level of evidence, 3. Methods: Radiographs and magnetic resonance imaging (MRI) scans of 1009 consecutive patients who underwent primary hip arthroscopy for FAIS from January 2012 to January 2016 were identified. Exclusion criteria were patients undergoing revision or bilateral surgery, patients with dysplasia, and patients with less than 2-year follow-up. On radiographs, SP joints were reviewed for joint surface erosions, subchondral sclerosis and cysts, and ankylosis. MRI scans were reviewed for marrow edema in the subarticular pubic bone, subchondral sclerosis and cysts, joint surface erosions, and ankylosis. Patients with SP abnormalities were matched 1:2 to patients without SP abnormalities by age and body mass index. Outcomes included the Hip Outcome Score–Activities of Daily Living (HOS-ADL), HOS–Sports Subscale (HOS-SS), modified Harris Hip Score (mHHS), International Hip Outcome Tool–12 (iHOT-12), and visual analog scales (VAS) for pain and satisfaction. Results: 830 patients were included; 23 (2.8%) demonstrated SP abnormalities. Of the 726 (72%) MRI scans reviewed, 15 (1.8%) showed bone marrow edema, subchondral sclerosis, erosions, or ankylosis. After matching, patients without SP abnormalities had significantly greater HOS-ADL (95.7 vs 83.0; P = .008), HOS-SS (91.6 vs 61.9; P = .003), iHOT-12 (89.5 vs 74.6; P = .046), and VAS satisfaction (91.3 vs 58.8; P = .004) scores, in addition to less postoperative pain (6.3 vs 23.5; P < .001). No significant differences were found in the mHHS (92.5 vs 82.2; P = .08). Patients without SP abnormalities had higher odds of achieving the minimal clinically important difference for the HOS-ADL (odds ratio [OR], 4.5; 95% CI, 1.3-14.1; P = .010), the HOS-SS (OR, 7.2; 95% CI, 1.8-18.5; P = .006), and the mHHS (OR, 14.5; 95% CI, 1.8-24.7; P = .013). Conclusion: A low prevalence (1.8%-2.6%) of SP joint abnormality is seen on imaging in patients with FAIS. These patients may demonstrate significantly inferior clinical outcomes and persistent postoperative pain after FAIS treatment.

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“…Like any other joint in the body, increased motion or stress across the articulation can stimulate an inflammatory cascade. This can lead to subchondral bony edema, subchondral cyst formation, and, ultimately, articular erosions [37]. This is akin to a stress reaction of the pubic symphysis from overuse and commonly secondary to increased compensatory motion through the pubic symphysis secondary to limited motion elsewhere within the kinetic chain (lumbopelvis, sacroiliac joint, FAI).…”

Section: Osteitis Pubismentioning

confidence: 99%

Hip and Groin Injuries in Baseball Players

Mlynarek

Coleman

2018

Curr Rev Musculoskelet Med

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(a) Limitations in throwing velocity, pitch control, and bat swing speed may be secondary to decreased mobility and strength within the proximal kinetic chain, which must harness power from the lower extremities and core. (b) Approximately 5.5% of all baseball injuries per year involve the hip/groin and may lead to a significant amount of time spent on the disabled list. Injuries involving the hip and groin are relatively common in baseball players. Our knowledge of the mechanics of overhead throwing continues to evolve, as does our understanding of the contribution of power from the lower extremities and core. It is paramount that the team physician be able to accurately diagnose and treat injuries involving the hip/groin, as they may lead to significant disability and inability to return to elite levels of play. This review focuses on hip- and groin-related injuries in the baseball player, including femoroacetabular impingement, core muscle injury, and osteitis pubis.

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Osteitis pubis in professional football players: MRI findings and correlation with clinical outcome

Cited by 23 publications

References 25 publications

Long-standing groin pain in contact sports: a prospective case–control and MRI study

Long-standing groin pain in contact sports: a prospective case–control and MRI study

Radiographic Prevalence of Symphysis Pubis Abnormalities and Clinical Outcomes in Patients With Femoroacetabular Impingement Syndrome

Hip and Groin Injuries in Baseball Players

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