Osteitis Pubis: Difference between revisions

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<div class="editorbox"> '''Original Editor '''- Shreya Pavaskar<br>
<div class="editorbox"> '''Original Editor '''- [[User:User Name|User Name]] <br>


  '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>
  '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>


== Description ==
== Clinically Relevant Anatomy<br>  ==
Osteitis pubis is chronic condition affecting the pubic symphysis and surrounding soft tissues. It is characterized by pain and local tenderness over the pubic symphysis. It commonly affects athletes, especially those who participate in sports that involve kicking, turning, twisting, cutting, pivoting, sprinting, rapid acceleration and deceleration or sudden directional changes. It is an overuse syndrome.


== Clinically Relevant Anatomy  ==
add text here relating to '''''clinically relevant''''' anatomy of the condition<br>


The pubic symphysis is a fibro-cartilaginous, non-synovial amphiarthrodial joint between left and right superior rami of the pubic bones. It is located in front of and below the urinary bladder. The center is avascular in nature. The ends of both pubic bones are covered by hyaline cartilage attached to the fibrocartilage. The fibro-cartilaginous disk is reinforced by ligaments. Adductor longus, Gracilis, Adductor brevis, Obturator externus and rectus abdominus muscles attach to pelvis.
== Mechanism of Injury / Pathological Process<br>  ==


== Mechanism of Injury  ==
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The exact etiology is not exactly been clarified and is still debated. Muscle imbalance between the abdominal and hip adductor muscles is currently considered the most important pathogenetic factor in the development of osteitis pubis. The adductors are antagonists to the abdominal muscles. Imbalances between abdominal and adductor muscle groups disrupt the equilibrium of forces around the pubic symphysis, predisposing the athlete to a subacute periostitis caused by chronic microtrauma. The cumulative microtrauma and altered biomechanics leads to instability and lesions. Reduced internal rotation of the hip, pregnancy, rheumatic disorders and instability of the sacroiliac joint  predisposing factors as they lead to increased shearing stress in the pelvis.<br>  
== Clinical Presentation  ==
 
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== Diagnostic Procedures  ==


== Clinical Presentation  ==
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-  Anterior and medial groin pain exaggerated by movement
== Outcome Measures  ==


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== Diagnostic Procedures ==
== Management / Interventions<br> ==
Plain Radiographs can be helpful in diagnosis of later stages and rule out other sources of groin pain. Radiographic changes may be present in chronic stages A Flamingo view (an anterior posterior view of the pelvis with patient standing on one leg) can give evidence of pelvic instability as a vertical subluxation greater than 2 mm or greater than 7 mm widening of symphysis are considered pathognomonic. A MRI can be used for detailed examination and may reveal edema. Bone scintigraphy may reveal increased tracer uptake in the pubic symphysis region<br>


== Medical Management ==
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Osteitis Pubis is usually self limiting usually improving with rest, ice and limited activity. Conservative treatment is beneficial and symptoms resolve spontaneously along with rest anti-inflammatory drugs are given to reduce inflammation. Other treatments include oral or injected corticosteroid and local anesthetics in the same region and surrounding tissues or dextrose prolotherapy however there limited evidence. Surgical management is done if treatment fails after 3 months of conservative management. All procedures can be associated adductor tendon release or with adductor enthesis repair Some authors suggested endoscopic pubic symphysectomy.


== Differential Diagnosis   ==
== Differential Diagnosis<br>  ==


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== Resources   ==
== Resources <br>  ==


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Revision as of 14:29, 20 September 2020

Original Editor - User Name
Top Contributors - Tehseen Zahra, Pacifique Dusabeyezu, Lucinda hampton, Kim Jackson, Shreya Pavaskar, Aminat Abolade, Candace Goh and Mohit Chand

Clinically Relevant Anatomy
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add text here relating to clinically relevant anatomy of the condition

Mechanism of Injury / Pathological Process
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add text here relating to the mechanism of injury and/or pathology of the condition

Clinical Presentation[edit | edit source]

add text here relating to the clinical presentation of the condition

Diagnostic Procedures[edit | edit source]

add text here relating to diagnostic tests for the condition

Outcome Measures[edit | edit source]

add links to outcome measures here (see Outcome Measures Database)

Management / Interventions
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add text here relating to management approaches to the condition

Differential Diagnosis
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add text here relating to the differential diagnosis of this condition

Resources
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add appropriate resources here

References[edit | edit source]

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