Verrall G M, Slavotinek J P, Fon G T
SPORTSMED-SA, Sports Medicine Clinic, Adelaide, Australia.
Br J Sports Med. 2001 Feb;35(1):28-33. doi: 10.1136/bjsm.35.1.28.
To examine the relation between the clinical features of groin pain and groin magnetic resonance imaging (MRI) appearances in a group largely comprising elite Australian Rules football players. The incidence of bone marrow oedema and other MRI findings in the pubic symphysis region was noted. The relation between a past history of groin pain and these other MRI findings was also examined.
In a prospective study, 116 male subjects (89 footballers, 17 umpires, 10 sedentary men) were examined before history taking and groin MRI. The clinical history was not known to the examiner (GMV) and radiologists (JPS, GTF). Clinical evidence of groin pain and examination findings were correlated with the presence of increased signal intensity within the pubic bone marrow. A past history of groin pain was correlated with the presence of other MRI findings such as cyst formation, fluid signal within the pubic symphysis disc, and irregularity of the pubic symphysis.
Fifty two athletes (47 footballers, five umpires) had clinical features of groin pain with pubic symphysis and/or superior pubic ramus tenderness. A high incidence of increased signal intensity (77%) within the pubic bone marrow was identified in this group. There was an association between this group of athletes and the MRI finding of increased signal intensity (p<0.01). There was also an association between a past history of groin pain and the presence of other MRI findings (p<0.01).
Athletes with groin pain and tenderness of the pubic symphysis and/or superior pubic ramus have clinical features consistent with the diagnosis of osteitis pubis. The increased signal intensity seen on MRI is due to pubic bone marrow oedema. An association exists between the clinical features of osteitis pubis and the MRI finding of pubic bone marrow oedema. A high incidence of pubic bone marrow oedema was also noted. Degenerative features visualised by MRI, such as subchondral cyst formation, were associated with a past history of groin pain. A stress injury to the pubic bone is the most likely explanation for these MRI findings and may be the cause of the clinical entity osteitis pubis.
在一个主要由澳大利亚式橄榄球精英运动员组成的群体中，研究腹股沟疼痛的临床特征与腹股沟磁共振成像（MRI）表现之间的关系。记录耻骨联合区域骨髓水肿及其他MRI表现的发生率。同时研究既往腹股沟疼痛病史与这些其他MRI表现之间的关系。
在一项前瞻性研究中，对116名男性受试者（89名足球运动员、17名裁判员、10名久坐男性）在进行病史采集和腹股沟MRI检查之前进行了检查。检查者（GMV）和放射科医生（JPS、GTF）并不知晓临床病史。腹股沟疼痛的临床证据和检查结果与耻骨骨髓内信号强度增加的情况相关联。既往腹股沟疼痛病史与其他MRI表现（如囊肿形成、耻骨联合椎间盘内液体信号以及耻骨联合不规则）的存在相关联。
52名运动员（47名足球运动员、5名裁判员）具有腹股沟疼痛的临床特征，伴有耻骨联合和/或耻骨上支压痛。在该组中发现耻骨骨髓内信号强度增加的发生率很高（77%）。这组运动员与MRI上信号强度增加的表现之间存在关联（p<0.01）。既往腹股沟疼痛病史与其他MRI表现的存在之间也存在关联（p<0.01）。
患有腹股沟疼痛且耻骨联合和/或耻骨上支压痛的运动员具有与耻骨炎诊断相符的临床特征。MRI上看到的信号强度增加是由于耻骨骨髓水肿。耻骨炎的临床特征与耻骨骨髓水肿的MRI表现之间存在关联。还注意到耻骨骨髓水肿的发生率很高。MRI显示的退行性特征，如软骨下囊肿形成，与既往腹股沟疼痛病史相关。耻骨的应力性损伤最有可能解释这些MRI表现，并且可能是耻骨炎这一临床病症的病因。
