Osteitis pubis is an overuse injury associated with groin pain.


Risk factors:

(1) running

(2) soccer

(3) any sport with overuse of the hip adductors

Clinical features:

(1) groin pain which may radiate to the thigh

(2) walking or other exercise may be associated with a popping sensation

(3) resisted adduction of the thigh elicits pain

(4) hopping on one foot causes pain

(5) pubic bone tenderness on palpation


Imaging studies:

(1) The most sensitive technique is a bone scan.

(2) In chronic and severe cases an X-ray may show changes in the pubic rami (irregularity, sclerosis, lytic lesions, erosions).

(3) MRI is useful and can demonstrate associated soft tissue and tendon injuries.


Differential diagnosis:

(1) pubic osteomyelitis

(2) other causes of groin pain


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