Osteitis pubis (rectal-adductor syndrome)

Case contributed by Dr Domenico Nicoletti


Fencing master with pubic pain for about six months.

Patient Data

Age: 55 years
Gender: Male

Pelvic radiograph

Thickened appearance of the articular surfaces of the pubic symphysis with normal joint space.

MRI pelvis

Bone marrow edema of both pubic bones close to the symphysis with associated edema of the insertion of the adductor muscles. The articular surfaces of the symphysis show some subchondral erosions and the joint space is narrow.

Case Discussion

Rectal-adductor syndrome is one of the most frequent forms of pubalgia. It consists of an insertional tendinopathy, of microtraumatic origin, due to the adductor muscles and/or the abdominal straight muscles.

In more advanced phases, an arthropathy of the pubic symphysis (pubic osteitis) can also be associated.

The causes are functional overload and repeated microtraumas of torsional and traction type in the tendon insertions of abdominals and adductors, in the presence of predisposing factors (postural alterations, dysmetria, incorrect plantar support).

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Case information

rID: 59746
Published: 23rd Apr 2018
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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