[Pubalgia in sportsmen]

Pubalgia is a painful syndrome of the groin which particularly affects young athletes. Although soccer players are the athletes most often affected, they are not alone. Also included in this group are fencers, tennis players and rugbymen. This ailment is associated with varying degrees of lesions of the muscles of the lower frontal abdomen, pubic symphysis and adductor muscles. The clinical diagnosis is confirmed by standard X-rays which can show radiological anomalies of the pubic symphysis in cases of microtraumatic pubic osteo-arthropathy or insertion tendinitis. Scintigraphic anomalies occur earlier than radiological anomalies and return to normal before them; thus allowing confirmation of healing even when the radiographs are still abnormal. Sonogram and MRI can be advantageous in the detection of a lesion of the abdominal muscles or adductor muscles. MRI can also detect a lesion of the pubic symphysis. The principal differential diagnosis is pubic osteitis. Treatment is medical and combines rest, analgesics and anti-inflammatories. Surgery, namely Nesovic's operation, is reserved for those forms resistant to medical treatment, and must be bilateral.