Case Of the Week (COW) 15 November 2015
OSTEITIS PUBIS
Findings:
Symmetric Para-symphyseal STIR hyperintensities are noted in both sides with minimal fluid within the pubic symphysis. No abnormal STIR hyperintensities noted in the common adductor-rectus abdominis aponeurosis.
Discussion:
Features consistent with OSTEITIS PUBIS. Osteitis pubis is most commonly seen in athletes participating in kicking sports such as soccer or Australian rules football. It is believed to result from instability of the pubic symphysis associated with repetitive shear and distraction injuries and an imbalance of the forces applied by the inserting abdominal wall and adductor muscle groups Osseous changes at the symphysis pubis frequently accompany injuries of the tendons and aponeurosis of the adductor longus and rectus abdominis MR imaging is recommended in 3 planes. Water-sensitive STIR or fat-suppressed T2-weighted images optimally display recent muscle and tendon injuries. In particular, sagittal images are most helpful in depicting the common adductor-rectus abdominis aponeurosis (CA-RA) Water-sensitive sequences detect increased marrow signal abnormalities within the pubis associated with stress-related changes, avulsive marrow edema, bone bruise or fracture. T1-weighted images are most helpful in depicting anatomy The earliest sign of osteitis pubis is diffuse subarticular marrow edema bordering the symphysis pubis, which is typically bilateral and generalized. subchondral bone marrow edema, fluid in symphysis pubis joint, and periarticular edema are the most reliable MRI findings of osteitis pubis that has a history of less than six months. Subchondral sclerosis, subchondral resorption and bony margin irregularities, and osteophytes (or pubic beaking) are the most reliable MRI findings of the chronic disease that has been present for more than six months.
EF: J Magn Reson Imaging. 2007 Mar;25(3):535-9. Magnetic resonance findings of osteitis pubis http://radsource.us/athletic-pubalgia.
Contributed By:
Prof. Babu Peter
Barnard Institute of Radiology
OSTEITIS PUBIS
Findings:
Symmetric Para-symphyseal STIR hyperintensities are noted in both sides with minimal fluid within the pubic symphysis. No abnormal STIR hyperintensities noted in the common adductor-rectus abdominis aponeurosis.
Discussion:
Features consistent with OSTEITIS PUBIS. Osteitis pubis is most commonly seen in athletes participating in kicking sports such as soccer or Australian rules football. It is believed to result from instability of the pubic symphysis associated with repetitive shear and distraction injuries and an imbalance of the forces applied by the inserting abdominal wall and adductor muscle groups Osseous changes at the symphysis pubis frequently accompany injuries of the tendons and aponeurosis of the adductor longus and rectus abdominis MR imaging is recommended in 3 planes. Water-sensitive STIR or fat-suppressed T2-weighted images optimally display recent muscle and tendon injuries. In particular, sagittal images are most helpful in depicting the common adductor-rectus abdominis aponeurosis (CA-RA) Water-sensitive sequences detect increased marrow signal abnormalities within the pubis associated with stress-related changes, avulsive marrow edema, bone bruise or fracture. T1-weighted images are most helpful in depicting anatomy The earliest sign of osteitis pubis is diffuse subarticular marrow edema bordering the symphysis pubis, which is typically bilateral and generalized. subchondral bone marrow edema, fluid in symphysis pubis joint, and periarticular edema are the most reliable MRI findings of osteitis pubis that has a history of less than six months. Subchondral sclerosis, subchondral resorption and bony margin irregularities, and osteophytes (or pubic beaking) are the most reliable MRI findings of the chronic disease that has been present for more than six months.
EF: J Magn Reson Imaging. 2007 Mar;25(3):535-9. Magnetic resonance findings of osteitis pubis http://radsource.us/athletic-pubalgia.
Contributed By:
Prof. Babu Peter
Barnard Institute of Radiology