Patricia Martina Cunningham MBBCH, Presenter: Nothing to Disclose

Darren D. Brennan MBBCH, Abstract Co-Author: Nothing to Disclose

Martin Joseph O'Connell MBBCh, Abstract Co-Author: Nothing to Disclose

Patrick O'Neill, Abstract Co-Author: Nothing to Disclose

Stephen John Eustace MD, Abstract Co-Author: Nothing to Disclose

To document the prevalence of isolated adductor dysfunction, of isolated osteitis pubis and of combined adductor dysfunction with osteitis pubis in high performance athletes with groin pain.

75 consecutive high performance athletes attending with groin pain over an 18 month period, in the absence of clinical evidence of sportsman’s hernia, underwent MRI on a 1.5T Philips Intera scanner. A body coil with coronal and axial T1 and STIR weighted tissue excitation was employed. Images were independently reviewed by 2 MSK radiologists and discrepancies resolved by consensus. Note was made of an ‘accessory cleft sign’ indicating adductor dysfunction, articular surface irregularity and para-articular bone oedema indicating osteitis pubis, and when present, whether changes were isolated or combined.

Accessory cleft reflecting adductor dysfunction was identified in 65 of 75 patients. In each case, the side of the cleft correlated with the side of groin pain. In 5 of 75 patients imaging revealed isolated osteitis pubis. In 30 patients imaging revealed both adductor dysfunction and osteitis pubis. Five patients had normal scans.

Adductor dysfunction reflected by an accessory cleft sign is the commonest cause of groin pain in athletes without a suspected hernia. Its presence appears to precede the development of osteitis pubis, with its surgical implications. Isolated osteitis pubis as a cause of groin pain in this population is uncommon.

Cunningham, P, Brennan, D, O'Connell, M, O'Neill, P, Eustace, S, MR Imaging in Groin Pain: Prevalence of Adductor Dysfunction and Osteitis Pubis in High Performance Athletes.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4412154.html