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Sports Medicine

, Volume 12, Issue 4, pp 266–279 | Cite as

Osteitis Pubis in Athletes

Infection, Inflammation or Injury?
  • Peter A. Fricker
  • Jack E. Taunton
  • Walter Ammann
Injury Clinic

Summary

Medical records of 59 patients (9 females and 50 males), who presented to sports medicine clinics at the Australian Institute of Sport and the University of British Columbia between 1985 and 1990 and who were diagnosed as suffering osteitis pubis, were reviewed and comparison of data obtained was made with the literature. Women average 35.5 years of age (30 to 59 years) and men 30.3 years (13 to 61 years). Sports most frequently involved were running, soccer, ice hockey and tennis. Clinical presentations of osteitis pubis fell into 4 main groups. ‘Mechanical’ (sport-related) was the largest group (n = 48), followed by ‘obstetric’ (n = 5), ‘inflammatory’ (n = 4) and ‘other’ (n = 2). Period of follow-up averaged 10.3 months (1 to 20 months) in women and 17.5 months (2 to 96 months) in men. Full recovery, when documented, averaged 9.5 months in men and 7.0 months in women. Osteitis pubis recurred in 25% of these men and none of these women at follow-up. The most frequent symptoms were pubic pain and adductor pain. Men also presented with lower abdominal, hip and perineal or scrotal pain; women with hip pain. Most common signs were tenderness of the pubic symphysis and tenderness of adductor longus muscle origin. Men also revealed tenderness of one or both the superior pubic rami and evidence of decreased hip rotation (unilateral or bilateral). Evidence of pelvic malalignment and/or sacroiliac dysfunction was frequently seen in both men and women. There was poor correlation between radiographic and isotope bone scan findings and the site and duration of symptoms and signs. Femoral head ratios were estimated on 30 hips in the series and 2 were judged to be at the upper limit of normal, perhaps indicating a form of epiphysiolysis producing tilt deformity of the head of the femur.

It is clear that osteitis pubis in athletes is not uncommon and that factors such as loss of rotation of hips and previous obstetric history are important in the aetiology and management of this condition. Pelvic infection, which was believed to be the primary factor of osteitis pubis in the literature up until the 1970s, plays a very small role in this condition in athletes.

Keywords

Symphysis Pubis Bone Scan Pelvic Infection Periostitis Internal Pudendal Artery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Adis International Limited 1991

Authors and Affiliations

  • Peter A. Fricker
    • 1
    • 2
    • 3
  • Jack E. Taunton
    • 1
    • 2
    • 3
  • Walter Ammann
    • 1
    • 2
    • 3
  1. 1.Department of Sports MedicineThe Australian Institute of SportCanberraAustralia
  2. 2.Allan McGavin Sports Medicine Centre, Department of Family Practice, School of Physical EducationUniversity of British ColumbiaVancouverCanada
  3. 3.Division of Nuclear Medicine, University HospitalUniversity of British ColumbiaVancouverCanada

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