Arvin Kheterpal MD, Presenter: Nothing to Disclose

William B. Morrison MD, Abstract Co-Author: Medical Advisory Board, ONI Medical Systems, Inc Medical Advisory Board, General Electric Company Consultant, Apriomed AB

William Clark Meyers MD, Abstract Co-Author: Nothing to Disclose

Suzanne S. Long MD, Abstract Co-Author: Nothing to Disclose

Adam C. Zoga MD, Abstract Co-Author: Nothing to Disclose

To analyze reproducible patterns of injuries sustained by American football players with clinical athletic pubalgia.

A retrospective study of 70 male football players (average age 22.3 years) with clinical athletic pubalgia was performed. All subjects underwent magnetic resonance (MR) imaging utilizing a dedicated athletic pubalgia protocol, to characterize the injuries anatomically. The patients completed a questionnaire, indicating their level of play, side of injury, and previous surgical history. MR imaging was reviewed to determine the number of unilateral (rectus abdominis/adductor) aponeurotic, bilateral aponeurotic, and midline pubic plate injuries. The presence and severity of osteitis pubis (graded as mild, moderate, or severe) and associated hip pathology was also analyzed.

Of the seventy subjects, there were 20 (28.6%) professional, 36 (51.4%) collegiate, 9 (12.9%) high school, and 5 (7.1%) recreational football players. Six subjects (8.6%) had a previous hernia repair, adductor release, or pelvic floor repair. There were 29 subjects (41.4%) who sustained midline pubic plate injuries, 31 subjects (44.3%) who sustained unilateral aponeurotic injuries, and 6 subjects (8.6%) who sustained bilateral aponeurotic injuries. Osteitis pubis was reported in 58 (82.9%) subjects, of which 32 (55.2%) were graded as moderate. Hip pathology was reported in 27 subjects (38.6%). Four subjects (5.7%) had isolated osteitis pubis and/or hip pathology.

Athletic pubalgia encompasses a wide spectrum of injuries involving the pelvis. Identification of reproducible patterns of injury in football players can be valuable in the development of preventive core-strengthening training. In this study, 41% of football players had midline pubic plate injuries, and 44% had unilateral aponeurotic injuries.

American football players are prone to athletic pubalgia injuries. Core-strengthening training aimed at the midline rectus abdominis/adductor aponeurotic plate may prevent many of these injuries.

Kheterpal, A, Morrison, W, Meyers, W, Long, S, Zoga, A, Patterns of Athletic Pubalgia in Football Players.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12034628.html