Osteitis pubis » Formation

An inflammation of the pubic joint that regularly affects athletes i.e. football players or marathon runners

The occurrence of an inflammation of the pubic joint (osteitis pubis (OP)) is mostly diagnosed in patients competing in contact sports like football, ice hockey, handball and basketball but can also be found in patients who complete an intensive running routine i.e. in preparation for a marathon.

Osteitis pubis (OP) diagnosed in patients without an athletic past is rare. It is often a coincidental discovery without therapeutic consequences. Other origins of discomforts have to be considered for the differential diagnosis of these patients.

During the examination of an inflammation of the pubic joint, patients refer to a chronic pain in the groin area. The pain increases during physical activity and cannot be treated satisfactory with common therapeutic procedures (physiotherapy, analgesics and local infiltration treatment).

Usually patients refer to a strong feeling of discomfort. An acute occurrence is rarely reported. The physical examination repeatedly shows typical symptoms of an inflammation of connecting muscles to the pubic bone (Os pubis). Special focus lies on the pressure pain at the insertion of adductor muscles M. adductor longus and M. gracilis.

Adduction pain against peripheral resistance is a regular phenomenon when the pubic joint is inflamed. Often pain occurs when doing sit-ups, rotating the thigh to the inside (passively), flexing the hip joint and abducting the legs in a lateral position.

During early acute stages of osteitis pubis, patients repeatedly complain about a dull resting pain even during night-time. This pain is related to an extended osseus (bone) edema. This particular point distinguishes the osteitis pubis (OP) clearly from other sporting injuries that cause discomfort in the groin area.

As a consequence of this developing pain without any apparent triggering event, the patient is often treated without further diagnostics in assumption of a strained groin or strained adductor muscles.

Frequently a physiotherapy treatment is prescribed or analgesic therapy conducted. Often patients attempt a program of self-medication, continuing their athletic efforts for several more weeks. Only when the persistent discomfort remains for several weeks further diagnostics are initiated. Untreated an osteitis pubis spontaneously heals after approximately 12 months.