Nielsen Mathias Fabricius, Hölmich Per, Branci Sonia, Torfing Trine, Ishøi Lasse, Nielsen Michael Bachmann, Thorborg Kristian
Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital - Amager-Hvidovre, Hvidovre, Denmark.
Department of Diagnostic Radiology, Rigshospitalet, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Scand J Med Sci Sports. 2025 May;35(5):e70068. doi: 10.1111/sms.70068.
The Aspetar pubic symphysis radiographic scoring protocol is reliable in male football players, but its clinical significance is unclear. We investigated the prevalence of pubic-related radiographic findings and their association with groin pain and disability in male football players and asymptomatic controls. We included 39 symptomatic male football players with long-standing groin pain, 18 asymptomatic male football players, and 20 asymptomatic male non-football athletes. Standing anteroposterior pelvic radiographs were analyzed by two radiologists for pubic-related bone lucency, proliferation, sclerosis, fragmentation, and joint space width (JSW, millimeters). Findings were combined into a Pubic Symphysis Radiographic Severity Score (PSRS Score, 0-8). Groin pain and disability were measured using the Five-Second Squeeze Test (5SST, 0-10) and the Hip and Groin Outcome Score (HAGOS, 100-0). For symptomatic football players, asymptomatic football players, and asymptomatic non-football athletes, the pubic-related radiographic findings prevalence's were, respectively: bone lucency: 87%, 83%, and 40%; proliferation: 67%, 61%, and 25%; sclerosis: 64%, 50%, and 15%; and fragmentations: 15%, 6%, and 0%, while the mean JSW was 3 mm in all three groups. There were no differences between symptomatic and asymptomatic football players in any findings (p ≥ 0.39). Bone lucency, proliferation, and sclerosis were more frequent in football players than non-football athletes (p < 0.002). PSRS Score showed poor correlation with 5SST and HAGOS. In conclusion, pubic-related radiographic findings are not associated with groin pain or disability. Pubic-related radiographic findings are more common in male football players than male non-football athletes.
阿斯佩塔尔耻骨联合放射学评分方案在男性足球运动员中是可靠的，但其临床意义尚不清楚。我们调查了男性足球运动员和无症状对照组中耻骨相关放射学表现的患病率及其与腹股沟疼痛和功能障碍的关联。我们纳入了39名有长期腹股沟疼痛的有症状男性足球运动员、18名无症状男性足球运动员和20名无症状男性非足球运动员。两名放射科医生对站立位骨盆前后位X线片进行分析，观察耻骨相关的骨质透亮、增生、硬化、碎裂以及关节间隙宽度（JSW，毫米）。将这些表现综合为耻骨联合放射学严重程度评分（PSRS评分，0 - 8分）。使用五秒挤压试验（5SST，0 - 10分）和髋部与腹股沟结局评分（HAGOS，100 - 0分）来测量腹股沟疼痛和功能障碍。对于有症状的足球运动员、无症状的足球运动员和无症状的非足球运动员，耻骨相关放射学表现的患病率分别为：骨质透亮：87%、83%和40%；增生：67%、61%和25%；硬化：64%、50%和15%；碎裂：15%、6%和0%，而三组的平均JSW均为3毫米。在任何表现方面，有症状和无症状的足球运动员之间均无差异（p≥0.39）。足球运动员中骨质透亮、增生和硬化比非足球运动员更常见（p<0.002）。PSRS评分与5SST和HAGOS的相关性较差。总之，耻骨相关放射学表现与腹股沟疼痛或功能障碍无关。耻骨相关放射学表现在男性足球运动员中比男性非足球运动员更常见。
