Pubic apophysitis: a previously undescribed clinical entity of groin pain in athletes
| Autor: | Rod Whiteley, Per Hölmich, John W Read, Bruno Giuffre, Matthieu Sailly, Amanda Johnson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
Abdominal pain medicine.medical_specialty Adolescent Physical Therapy Sports Therapy and Rehabilitation Pubic symphysis Physical examination Growth Groin Joint capsule Soccer Medicine Humans Orthopedics and Sports Medicine Child Physical Examination Tendon Pelvic medicine.diagnostic_test business.industry Arthritis Pubic Symphysis General Medicine medicine.disease Magnetic Resonance Imaging Surgery Abdominal Pain body regions medicine.anatomical_structure Bankart lesion Case-Control Studies Original Article medicine.symptom business Cadaveric spasm Tomography X-Ray Computed Apophysitis |
| Zdroj: | British Journal of Sports Medicine |
| ISSN: | 1473-0480 0306-3674 |
| Popis: | Background Sport-related pubalgia is often a diagnostic challenge in elite athletes. While scientific attention has focused on adults, there is little data on adolescents. Cadaveric and imaging studies identify a secondary ossification centre located along the anteromedial corner of pubis beneath the insertions of symphysial joint capsule and adductor longus tendon. Little is known about this apophysis and its response to chronic stress. Aim We report pubic apophysitis as a clinically relevant entity in adolescent athletes. Methods The clinical and imaging findings in 26 highly trained adolescent football players (15.6 years±1.3) who complained of adductor-related groin pain were reviewed. The imaging features (X-ray 26/26, US 9/26, MRI 11/26, CT 7/26) of the pubic apophyses in this symptomatic group were compared against those of a comparison group of 31 male patients (age range 9–30 years) with no known history of groin pain or pelvic trauma, who underwent pelvic CT scans for unrelated medical reasons. Results All symptomatic subjects presented with similar history and physical findings. The CT scans of these patients demonstrated open pubic apophyses with stress-related physeal changes (widening, asymmetry and small rounded cyst-like expansions) that were not observed in the comparison group. No comparison subject demonstrated apophyseal maturity before 21 years of age, and immaturity was seen up to the age of 26 years. Conclusions This retrospective case series identifies pubic apophyseal stress (or ‘apophysitis’) as an important differential consideration in the adolescent athlete who presents with groin pain. |
| Databáze: | OpenAIRE |
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