Presentation
Chronic left pubic pain.
Patient Data
Tear of 19 mm extension, at the level of the insertion of the left common adductor tendon on the pubic symphysis. It conditions disruption of the common aponeurosis at that level, with cephalic extension and partial tearing of the lateral insertion of the ipsilateral rectus abdominis.
Subperiosteal edema of the pubis, in relation to reactive osteitis and myofibrillar edema of the adductor longus muscle on the left side.
The image on the left shows the pathological side, to the left of the midline of the pubis, showing a tear in the adductor tendon (blue arrowhead), with the compromise of the common aponeurosis (red asterisk) and hyperintense signal at the interface of the aponeurosis and anterior pubis (superior cleft sign), with adjacent bone marrow edema.
For comparison, the image on the right shows the normal hypointense signal from the adductor and rectus abdominal tendons, as well as from the common aponeurosis. Note the normal low signal at the interface of the aponeurosis and anterior pubis.
Case Discussion
Pain in the inguinal or peri-inguinal region related to sports practice can be included in the term pubalgia. It represents a multi-casual pathology with non-specific symptoms, which makes it necessary to rule out other etiologies.
Knowing the complex anatomy of the musculotendinous and ligamentous structures of the pubic region through MRI helps to carry out a correct diagnostic and, therefore, therapeutic approach.
Unable to process the form. Check for errors and try again.