Osteitis pubis

• pubic symphysis is a fibrocartilaginous joint
  • osteitis pubis is a painful inflammatory condition of the pubic symphysis
    
    
• most commonly occurs in 30-40 years old men who participate in football, basketball or long distance running (1)
  
  
• mainly caused by impaction trauma but may also be a result of primary inflammation, childbirth or secondary to infection
  
  
• a sudden increase in the frequency, intensity or duration of training, limited range of motion of the hip, or weakness of the hip abductors or adductors, can result in osteitis pubis
  

Investigations and diagnosis:

• diagnosis confirmed radiologically where on a plain AP X-ray of the pelvis, findings include bilateral subchondral irregularity, bone erosions and cysts
• note also:
  • isotope bone scan will show a localized increased uptake of the isotope
  • MRI scan will demonstrate bone marrow oedema

Treatment options include:

• physiotherapy for core stabilization, stretching and strengthening exercises of abdominal, hip adductor and abductor muscles, steroid and local anaesthetic or surgery
• operative procedures include wedge resection of the symphysis pubis, curettage or symphysiodesis

Reference:

• 1) Haider NR, Syed RA, Dermady D. Osteitis pubis: an important pain generator in women with lower pelvic or abdominal pain: a case report and literature review. Pain Physician 2005; 8: 145-7