Andrews S K, Carek P J
Department of Family Medicine, Medical University of South Carolina, Charleston, USA.
J Am Board Fam Pract. 1998 Jul-Aug;11(4):291-5. doi: 10.3122/jabfm.11.4.291.
Osteitis pubis was first described in 1924 in patients who had had suprapubic surgery. Since that time many theories concerning the cause of the disease have been developed. Published case reports and retrospective record reviews of specific, isolated patient populations have been used to postulate an infectious, inflammatory, or traumatic cause of this condition. Such confusion reduces the likelihood of an accurate diagnosis of osteitis pubis, particularly in the primary care setting, where it is becoming increasingly likely that patients afflicted with this frustrating illness will initially seek treatment.
This article describes a case report and provides a review of the literature. The medical literature was searched using the following key words: "abdominal pain," "pelvic pain," "inflammation," "symphysis pubis," and "enthesopathy."
Osteitis pubis, considered to be the most common inflammatory disease of the pubic symphysis, is a self-limiting inflammation secondary to trauma, pelvic surgery, childbirth, or overuse, and it can be found in almost any patient population. Occurring more commonly in men during their 30s and 40s, osteitis pubis causes pain in the pubic area, one or both groins, and in the lower rectus abdominis muscle. The pain can be exacerbated by exercise or specific movements, such as running, kicking, or pivoting on one leg, and is relieved with rest. Pain can occur with walking and can be in one or several of many distributions: perineal, testicular, suprapubic, inguinal, and postejaculatory in the scrotum and perineum. Symptoms are described as "groin burning," with discomfort while climbing stairs, coughing, or sneezing. A greater understanding and awareness of osteitis pubis will reduce patient and physician frustration while improving overall outcomes.
耻骨炎于1924年首次在接受耻骨上手术的患者中被描述。从那时起，关于该病病因的许多理论相继提出。已发表的病例报告以及对特定、孤立患者群体的回顾性记录分析被用于推测这种病症的感染性、炎症性或创伤性病因。这种混淆降低了准确诊断耻骨炎的可能性，尤其是在初级保健环境中，患有这种令人沮丧疾病的患者越来越有可能首先在此寻求治疗。
本文描述了一例病例报告并对文献进行了综述。使用以下关键词搜索医学文献：“腹痛”“盆腔疼痛”“炎症”“耻骨联合”和“附着点病”。
耻骨炎被认为是耻骨联合最常见的炎症性疾病，是一种继发于创伤、盆腔手术、分娩或过度使用的自限性炎症，几乎在任何患者群体中都可能出现。耻骨炎在30多岁和40多岁的男性中更为常见，会导致耻骨区域、一侧或双侧腹股沟以及下腹直肌疼痛。运动或特定动作（如跑步、踢腿或单腿旋转）会使疼痛加剧，休息后疼痛缓解。行走时也可能出现疼痛，疼痛分布可能为会阴、睾丸、耻骨上、腹股沟以及射精后阴囊和会阴处的一处或多处。症状被描述为“腹股沟灼痛”，爬楼梯、咳嗽或打喷嚏时会感到不适。对耻骨炎有更深入的理解和认识将减少患者和医生的挫败感，同时改善总体治疗效果。
