Osteitis pubis

Case contributed by Gaurav Som Prakash Gupta
Diagnosis almost certain

Presentation

Referred for MRI due to ultrasound-detected right ovarian cyst. Presented with vague lower abdominal pain. History of recent full term normal vaginal delivery.

Patient Data

Age: 40 years
Gender: Female

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

mri

The MRI reveals edema in the parasymphyseal region of the pubic bone - mainly on the right side but also minimally on the left side.

The post-contrast image (fat subtraction images) reveals enhancement in the region of bone edema. 

In the sagittal images, the ovarian cyst is visible (not the subject of presentation in the present case).

Case Discussion

The MRI findings are consistent with osteitis pubis. The ovarian cyst seems to be an incidental finding as the primary patient presented with pain lower abdomen which, increased on walking and reduced on resting. 

She is a 40 year old female with a history of recent full-term vaginal delivery (2 months ago). She is not an athlete or sportswoman. The vaginal delivery may be the reason of osteitis pubis in this case, however, there are only few case reports describing the osteitis pubis following vaginal delivery. 

Diagnosis is mainly based on correlation of clinical data and the MRI findings. No further confirmation was done.

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