Athletic Pubalgia

about ultrasound findings of athletic pubalgia

The pubic symphysis region has a complex anatomy and biomechanics, with large number of potential sources of groin pain and different types or sites of injury that can be present in the same patient.

Today I want to show you the usefulness of the rectus abdominis-adductor longus tendon dynamic ultrasound examination. I always suggest to have a direct visualization of both these important structures that work togheter as antagonists of one another during rotation and extension from the waist.

Professional soccer player with groin pain: the Mri exam shows gross irregularity of the pubic symphysis cortical bone, with cleft sign alongside the right pubic body (arrow) and a partial strain and chronic tendinopathy of the right adductor longus tendon.

athletic-pubalgia

Coronal Pdw Spair (left) and T1w (right) Mri scans (1.5 Tesla).

Same findings are present in this patient at the pubic attachment of right rectus abdominis tendon.

rectus-abdominis

Sagittal (left) and Coronal (right) Pdw spair Mri scans (1.5 tesla).

Ultrasound dynamic examination with active muscle contraction is crucial in this kind of injuries.

In this patient a Spigelian hernia was also detected during provocative  Valsalva maneuvers over linea semilunaris.

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