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.

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.

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.