Recurrent bilateral inguinal pain, mostly on the left side. Clinical image seemed to be that of femoro-acetabular impingement, but now the pain is more localized around the pubic bone and left adductor magnus insertion. Osteitis pubis?
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Bone marrow edema in the medial left pubic bone, no edema outside of the bone. No secondary cleft sign.
Normal appearance of tendons and aponeurosis of rectus abdominis-adductor longus.
Normal femoral heads. No inguinal hernia.
Findings consistent with osteitis pubis.
Osteitis pubis is one of the pathologic entities grouped together as athletic pubalgia, which involves either a musculotendinous or osseous injury of the insertion of the rectus abdominis and the origin of the adductor longus, which come together in an aponeurosis on the pubic bones.