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Pubic apophysitis – an important cause of groin pain in young athletes
  1. David F Hanff1,
  2. Astrid van Ovost2,
  3. Bruce B Forster3,
  4. Adam Weir2
  1. 1Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, Netherlands
  2. 2Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, Netherlands
  3. 3Department of Radiology, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
  1. Correspondence to Drs David F Hanff; d.hanff{at}erasmusmc.nl

https://doi.org/10.1136/bjsports-2024-108710

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    History

    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.

    Imaging findings

    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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    Footnotes

    • X @Davidhanff3, @brucebforster

    • Contributors DFH: writing manuscript, editing, conducting. AvO: writing, editing. BBF: writing, editing, directing the project. AW: writing, planning, designed and directing the project. DFH is the guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.