Osteitis Pubis: Difference between revisions
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== Diagnosis == | == Diagnosis == | ||
On palpation tenderness is common over symphyseal region. Several tests are performed such as pubic symphysis gap test with isometric adductor contraction and lateral compression test. Some provocation tests are helpful i.e single adductor, squeeze and bilateral adductor tests(best) for the assessment of chronic groin pain. Clinical findings can also include Positive FABER test , restricted range of hip motion, sacroiliac | On palpation tenderness is common over symphyseal region. Several tests are performed such as pubic symphysis gap test with isometric adductor contraction and lateral compression test. Some provocation tests are helpful i.e single adductor, squeeze and bilateral adductor tests(best) for the assessment of chronic groin pain. Clinical findings can also include Positive [https://physio-pedia.com/FABER_Test?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal FABER test] , restricted range of hip motion, sacroiliac joint dysfunction and weakness of abductor or adductor muscles. Along with that radiographs, MRI, triple-phase scintigraphy confirms the diagnosis and exclude any other cause of groin pain.<ref name=":0" /> | ||
== Differential Diagnosis == | == Differential Diagnosis == | ||
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• sports hernia | • sports hernia | ||
• athletic pubalgia, | • athletic [https://physio-pedia.com/Pubalgia?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal pubalgia,] | ||
• indirect inguinal hernia, | • indirect inguinal hernia, | ||
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• adductor or iliopsoas injury, | • adductor or iliopsoas injury, | ||
• Femoro- acetabular impingement | • [https://physio-pedia.com/Femoroacetabular_Impingement?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal Femoro- acetabular impingement] | ||
• acetabular labral tear, | • [https://physio-pedia.com/Diagnosis_of_Acetabular_Labral_Tears?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal acetabular labral tear,] | ||
• pelvic stress fracture, | • pelvic stress fracture, | ||
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== Epidemiology == | == Epidemiology == | ||
Osteitis pubis is common cause of groin pain in athletes. The incidence in athletes is 0.5%–8%, with a higher incidence in distance runners and athletes participating in kicking sports, ,mostly in male soccer players with 10%–18% of injuries per year.<ref name=":0" /> | |||
== Management / Interventions == | == Management / Interventions == | ||
Revision as of 06:25, 21 September 2020
Original Editor - Tehseen Zahra
Introduction[edit | edit source]
Osteitis pubis is a painful and chronic condition which is common in athletes affecting the pubic symphysis and parasymphyseal bone and it occurs after athletic activity.[1] It is actually an overuse condition caused by abnormal muscle forces acting on the pubic symphysis .[2] It causes pelvic pain and local tenderness over pubic symphysis. It commonly occurs in athletes who participate in sports involving kicking, twisting , pivoting,cutting and during abrupt directional changes.Osteitis pubis has been described in soccer, rugby, ice hockey,distance running players.[3]
Clinically Relevant Anatomy[edit | edit source]
Pubic symphysis is found anteriorly between adjacent pubic bounds covered in hyaline cartilage.It is stabilized by superior pubic ligament and inferior pubic ligament.[Gray's anatomy]
Mechanism of Injury[edit | edit source]
Centre of gravity of the body is located within pelvis that’s why it is greatly stressed in all athletic activities. The biomechanical forces are applied through the pelvis of an athlete during kicking, acceleration and deceleration which increases the incidence of osteitis pubis. These forces causes chronic overloading of pubic symphysis and parasymphyseal bone leading to bony stress reaction.[4]
Clinical Presentation[edit | edit source]
Athlete with osteitis pubis presents with anterior and medial groin pain or it may be located directly over pubic symphysis. Pain may also occur in the lower abdominal muscles, adductor region, perineal region, inguinal and scrotum which is aggravated by running, cutting, hip adduction,flexion against resistance and by activities that causes loading on rectus abdominis. [1]
Diagnosis[edit | edit source]
On palpation tenderness is common over symphyseal region. Several tests are performed such as pubic symphysis gap test with isometric adductor contraction and lateral compression test. Some provocation tests are helpful i.e single adductor, squeeze and bilateral adductor tests(best) for the assessment of chronic groin pain. Clinical findings can also include Positive FABER test , restricted range of hip motion, sacroiliac joint dysfunction and weakness of abductor or adductor muscles. Along with that radiographs, MRI, triple-phase scintigraphy confirms the diagnosis and exclude any other cause of groin pain.[3]
Differential Diagnosis[edit | edit source]
• direct inguinal hernia,
• sports hernia
• athletic pubalgia,
• indirect inguinal hernia,
• adductor or iliopsoas injury,
• Femoro- acetabular impingement
• pelvic stress fracture,
• femoral neck stress fracture,
• lumbar spine referred pain,
• ilioinguinal neuralgia,
• Osteomyelitis can be considered but less common cause in athletes.[4]
Epidemiology[edit | edit source]
Osteitis pubis is common cause of groin pain in athletes. The incidence in athletes is 0.5%–8%, with a higher incidence in distance runners and athletes participating in kicking sports, ,mostly in male soccer players with 10%–18% of injuries per year.[3]
Management / Interventions[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 Hiti CJ, Stevens KJ, Jamati MK, Garza D, Matheson GO. Athletic osteitis pubis. Sports medicine. 2011 May 1;41(5):361-76.
- ↑ Johnson R. Osteitis pubis. Current sports medicine reports. 2003 Mar 1;2(2):98-102.
- ↑ 3.0 3.1 3.2 Via AG, Frizziero A, Finotti P, Oliva F, Randelli F, Maffulli N. Management of osteitis pubis in athletes: rehabilitation and return to training–a review of the most recent literature. Open Access Journal of Sports Medicine. 2019;10:1.
- ↑ 4.0 4.1 Beatty T. Osteitis pubis in athletes. Current sports medicine reports. 2012 Mar 1;11(2):96-8.
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