Besjakov J, von Scheele C, Ekberg O, Gentz C F, Westlin N E
Department of Diagnostic Radiology, Malmö University Hospital, Malmö, Sweden.
Acta Radiol. 2003 Jan;44(1):79-83.
Radiographic abnormalities in the pubic bone and symphysis are often seen in athletes with groin pain. The aim was to create a grading scale of such radiologic changes.
Plain radiography of the pelvic ring including the pubic bone and the symphysis was performed in 20 male athletes, age 19-35, with long-standing uni- or bilateral groin pain. We used two control groups: Control group 1: 20 healthy age-matched men who had undergone radiologic examination of the pelvis due to trauma. Control group 2: 120 adults (66 men and 54 women) in 9 age groups between 15 and 90 years of age. These examinations were also evaluated for interobserver variance.
The grading scale was based on the type and the amount of the different changes, which were classified as follows: No bone changes (grade 0), slight bone changes (grade 1), intermediate changes (grade 2), and advanced changes (grade 3). The grading scale is easy to interpret and an otherwise troublesome communication between the radiologist and the physician was avoided. There was a high interobserver agreement with a high kappa value (0.8707). Male athletes with long-standing groin pain had abnormal bone changes in the symphysis significantly more frequently and more severely (p>0.001) than their age-matched references. In asymptomatic individuals such abnormalities increased in frequency with age both in men and women.
耻骨和耻骨联合的影像学异常在患有腹股沟疼痛的运动员中很常见。目的是创建此类放射学改变的分级量表。
对20名年龄在19 - 35岁、患有长期单侧或双侧腹股沟疼痛的男性运动员进行了包括耻骨和耻骨联合在内的骨盆环的X线平片检查。我们使用了两个对照组：对照组1：20名年龄匹配的健康男性，他们因外伤接受了骨盆的放射学检查。对照组2：120名年龄在15至90岁之间的9个年龄组的成年人（66名男性和54名女性）。这些检查也评估了观察者间的差异。
分级量表基于不同改变的类型和程度，分类如下：无骨质改变（0级）、轻度骨质改变（1级）、中度改变（2级）和重度改变（3级）。该分级量表易于解读，避免了放射科医生和内科医生之间原本麻烦的沟通。观察者间一致性高，kappa值高（0.8707）。患有长期腹股沟疼痛的男性运动员耻骨联合处的骨质异常比年龄匹配的对照者更频繁、更严重（p>0.001）。在无症状个体中，此类异常在男性和女性中均随年龄增加而增多。
