Zeitoun F, Frot B, Sterin P, Tubiana J M
Service de Radiologie, Hôpital Saint-Antoine, Paris.
Ann Radiol (Paris). 1995;38(5):244-54.
Pubalgia is a painful syndrome of the groin which particularly affects young athletes. Although soccer players are the athletes most often affected, they are not alone. Also included in this group are fencers, tennis players and rugbymen. This ailment is associated with varying degrees of lesions of the muscles of the lower frontal abdomen, pubic symphysis and adductor muscles. The clinical diagnosis is confirmed by standard X-rays which can show radiological anomalies of the pubic symphysis in cases of microtraumatic pubic osteo-arthropathy or insertion tendinitis. Scintigraphic anomalies occur earlier than radiological anomalies and return to normal before them; thus allowing confirmation of healing even when the radiographs are still abnormal. Sonogram and MRI can be advantageous in the detection of a lesion of the abdominal muscles or adductor muscles. MRI can also detect a lesion of the pubic symphysis. The principal differential diagnosis is pubic osteitis. Treatment is medical and combines rest, analgesics and anti-inflammatories. Surgery, namely Nesovic's operation, is reserved for those forms resistant to medical treatment, and must be bilateral.
耻骨痛是一种腹股沟疼痛综合征,尤其影响年轻运动员。虽然足球运动员是最常受影响的运动员群体,但并不局限于此。这个群体还包括击剑运动员、网球运动员和橄榄球运动员。这种疾病与下腹前侧肌肉、耻骨联合和内收肌的不同程度损伤有关。临床诊断通过标准X线检查来确认,在微创伤性耻骨骨关节炎或附着点肌腱炎的情况下,X线可显示耻骨联合的放射学异常。闪烁扫描异常比放射学异常出现得早,且在放射学异常恢复正常之前就恢复正常;因此,即使X线片仍显示异常,也能确认愈合情况。超声检查和磁共振成像(MRI)有助于检测腹部肌肉或内收肌的损伤。MRI还能检测耻骨联合的损伤。主要的鉴别诊断是耻骨骨炎。治疗采用药物治疗,包括休息、使用止痛剂和抗炎药。手术,即内索维奇手术,仅适用于药物治疗无效的病例,且必须双侧进行。