La pubalgia nello sportivo: quadri RM di “Osteite Pubica"

Pubalgia is a painful syndrome, sometimes invalidating, involving agonist and non-agonist sportsman. It represents 2-5% of sport-related diseases in agonist sportsman and its cause is not always easily diagnosed. Osteitis pubis represents one of its more frequent causes involving sportsman in 0.5-0.7% of cases. Between September 2003 to August 2004, 40 athletes, 37 men and 3 women (age range 18-37 years; mean age: 24 years), with clinical evidence of pubalgia were submitted to pelvic MR. In all cases symptoms were unilateral (33%) or bilateral (67%), irradiating to adductor region and to rectus abdominis muscle, presenting ingravescent evolution. MR shows primitive pubic osteitis in 21 cases (5 cases early stage and 16 cases in late stage). Changes of pubic bones and myo-tendinous junctions were assessed in 16/16 cases in late stage. Muscle involvement was observed in 19/21 cases and cortical edge changes were assessed in 12/16 cases. Only in one case we observed extant joint effusion and a millimetric calcification. RM, due to its intrinsic characteristics of high contrast resolution and multiplanarity, is the most suitable imaging technique allowing osseous, capsulo-ligamentous, tendinous and muscular changes evaluation and its balance of extension in early and late stages, permits a correct therapeutical planning and follow-up