Risk factors:
(1) running
(2) soccer
(3) any sport with overuse of the hip adductors
Clinical features:
(1) groin pain which may radiate to the thigh
(2) walking or other exercise may be associated with a popping sensation
(3) resisted adduction of the thigh elicits pain
(4) hopping on one foot causes pain
(5) pubic bone tenderness on palpation
Imaging studies:
(1) The most sensitive technique is a bone scan.
(2) In chronic and severe cases an X-ray may show changes in the pubic rami (irregularity, sclerosis, lytic lesions, erosions).
(3) MRI is useful and can demonstrate associated soft tissue and tendon injuries.
Differential diagnosis:
(1) pubic osteomyelitis
(2) other causes of groin pain
