Osteitis Pubis

Original Editor - Shreya Pavaskar
Top Contributors - Tehseen Zahra, Lucinda hampton, Pacifique Dusabeyezu, Kim Jackson, Shreya Pavaskar and Aminat Abolade

Description

Osteitis pubis is chronic condition affecting the pubic symphysis and surrounding soft tissues. It is characterized by pain and local tenderness over the pubic symphysis. It commonly affects athletes, especially those who participate in sports that involve kicking, turning, twisting, cutting, pivoting, sprinting, rapid acceleration and deceleration or sudden directional changes. It is an overuse syndrome.

Clinically Relevant Anatomy

The pubic symphysis is a fibro-cartilaginous,non-synovial amphiarthrodial joint between left and right superior rami of the pubic bones. It is located in front of and below the urinary bladder. The center is avascular in nature.The ends of both pubic bones are covered by hyaline cartilage attached to the fibrocartilage. The fibroc-artilaginous disk is reinforced by ligaments. Adductor longus, Gracilis, Adductor brevis, Obturator externus and rectus abdominus muscles attach to pelvis.

Mechanism of Injury

The exact etiology is not exactly been clarified and is still debated.Muscle imbalance between the abdominal and hip adductor muscles is currently considered the most important pathogenetic factor in the development of osteitis pubis. The adductors are antagonists to the abdominal muscles. Imbalances between abdominal and adductor muscle groups disrupt the equilibrium of forces around the pubic symphysis, predisposing the athlete to a subacute periostitis caused by chronic microtrauma. The cumulative microtrauma and altered biomechanics leads to instability and lesions. Reduced internal rotation of the hip,pregnancy, rheumatic disorders and instability of the sacroiliac joint predisposing factors as they lead to increased shearing stress in the pelvis.

Clinical Presentation

-  Anterior and medial groin pain exaggerated by movement

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Diagnostic Procedures

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Outcome Measures

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Management / Interventions

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Differential Diagnosis

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Resources

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References

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