Athletic pubalgia and the "sports hernia"

MR imaging findings

Adam C. Zoga, Eoin C. Kavanagh, Imran M. Omar, William B. Morrison, George Koulouris, Hector Lopez, Avneesh Chhabra, John Domesek, William C. Meyers

Research output: Contribution to journalArticle

Abstract

Purpose: To retrospectively determine the sensitivity and specificity of magnetic resonance (MR) imaging findings in patients with clinical athletic pubalgia, with either surgical or physical examination findings as the reference standard. Materials and Methods: Institutional review board approval was granted for this HIPAA-compliant study, and informed consent was waived. MR imaging studies in 141 patients (134 male patients, seven female patients; mean age, 30.1 years; range, 17-71 years) who had been referred to a subspecialist because of groin pain were reviewed for findings including hernia, pubic bone marrow edema, secondary cleft sign, and rectus abdominis and adductor tendon injury. MR imaging findings were compared with surgical findings for 102 patients, physical examination findings for all 141 patients, and MR imaging findings in an asymptomatic control group of 25 men (mean age, 29.8 years; range, 18-39 years). Sensitivity and specificity of MR imaging for rectus abdominis and adductor tendon injury were determined by using a χ2analysis, and significance of the findings was analyzed with an unpaired Student t test. Disease patterns seen at MR imaging were compared with those reported in the surgical and sports medicine literature. Results: One hundred thirty-eight (98%) of 141 patients had findings at MR imaging that could cause groin pain. Compared with surgery, MR imaging had a sensitivity and specificity, respectively, of 68% and 100% for rectus abdominis tendon injury and 86% and 89% for adductor tendon injury. Injury in each of these structures was significantly more common in the patient group than in the control group (P < .001). Only two patients had hernias at surgery. At MR imaging, injury or disease could be fit into distinct groups, including osteitis pubis, adductor compartment injury, rectus abdominis tendon injury, and injury or disease remote from the pubic symphysis. Patients with injury involving the rectus abdominis insertion were most likely to go on to surgical pelvic floor repair. Conclusion: MR imaging depicts patterns of findings in patients with athletic pubalgia, including rectus abdominis insertional injury, thigh adductor injury, and articular diseases at the pubic symphysis (osteitis pubis).

Original languageEnglish (US)
Pages (from-to)797-807
Number of pages11
JournalRadiology
Volume247
Issue number3
DOIs
StatePublished - Jun 1 2008
Externally publishedYes

Fingerprint

Hernia
Sports
Magnetic Resonance Imaging
Rectus Abdominis
Tendon Injuries
Pubic Bone
Wounds and Injuries
Pubic Symphysis
Osteitis
Groin
Sensitivity and Specificity
Physical Examination
Health Insurance Portability and Accountability Act
Pain
Control Groups
Sports Medicine
Pelvic Floor
Research Ethics Committees
Thigh
Informed Consent

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Zoga, A. C., Kavanagh, E. C., Omar, I. M., Morrison, W. B., Koulouris, G., Lopez, H., ... Meyers, W. C. (2008). Athletic pubalgia and the "sports hernia": MR imaging findings. Radiology, 247(3), 797-807. https://doi.org/10.1148/radiol.2473070049

Athletic pubalgia and the "sports hernia" : MR imaging findings. / Zoga, Adam C.; Kavanagh, Eoin C.; Omar, Imran M.; Morrison, William B.; Koulouris, George; Lopez, Hector; Chhabra, Avneesh; Domesek, John; Meyers, William C.

In: Radiology, Vol. 247, No. 3, 01.06.2008, p. 797-807.

Research output: Contribution to journalArticle

Zoga, AC, Kavanagh, EC, Omar, IM, Morrison, WB, Koulouris, G, Lopez, H, Chhabra, A, Domesek, J & Meyers, WC 2008, 'Athletic pubalgia and the "sports hernia": MR imaging findings', Radiology, vol. 247, no. 3, pp. 797-807. https://doi.org/10.1148/radiol.2473070049
Zoga AC, Kavanagh EC, Omar IM, Morrison WB, Koulouris G, Lopez H et al. Athletic pubalgia and the "sports hernia": MR imaging findings. Radiology. 2008 Jun 1;247(3):797-807. https://doi.org/10.1148/radiol.2473070049
Zoga, Adam C. ; Kavanagh, Eoin C. ; Omar, Imran M. ; Morrison, William B. ; Koulouris, George ; Lopez, Hector ; Chhabra, Avneesh ; Domesek, John ; Meyers, William C. / Athletic pubalgia and the "sports hernia" : MR imaging findings. In: Radiology. 2008 ; Vol. 247, No. 3. pp. 797-807.
@article{4afbb4321c9543d695a8c0087a045931,
title = "Athletic pubalgia and the {"}sports hernia{"}: MR imaging findings",
abstract = "Purpose: To retrospectively determine the sensitivity and specificity of magnetic resonance (MR) imaging findings in patients with clinical athletic pubalgia, with either surgical or physical examination findings as the reference standard. Materials and Methods: Institutional review board approval was granted for this HIPAA-compliant study, and informed consent was waived. MR imaging studies in 141 patients (134 male patients, seven female patients; mean age, 30.1 years; range, 17-71 years) who had been referred to a subspecialist because of groin pain were reviewed for findings including hernia, pubic bone marrow edema, secondary cleft sign, and rectus abdominis and adductor tendon injury. MR imaging findings were compared with surgical findings for 102 patients, physical examination findings for all 141 patients, and MR imaging findings in an asymptomatic control group of 25 men (mean age, 29.8 years; range, 18-39 years). Sensitivity and specificity of MR imaging for rectus abdominis and adductor tendon injury were determined by using a χ2analysis, and significance of the findings was analyzed with an unpaired Student t test. Disease patterns seen at MR imaging were compared with those reported in the surgical and sports medicine literature. Results: One hundred thirty-eight (98{\%}) of 141 patients had findings at MR imaging that could cause groin pain. Compared with surgery, MR imaging had a sensitivity and specificity, respectively, of 68{\%} and 100{\%} for rectus abdominis tendon injury and 86{\%} and 89{\%} for adductor tendon injury. Injury in each of these structures was significantly more common in the patient group than in the control group (P < .001). Only two patients had hernias at surgery. At MR imaging, injury or disease could be fit into distinct groups, including osteitis pubis, adductor compartment injury, rectus abdominis tendon injury, and injury or disease remote from the pubic symphysis. Patients with injury involving the rectus abdominis insertion were most likely to go on to surgical pelvic floor repair. Conclusion: MR imaging depicts patterns of findings in patients with athletic pubalgia, including rectus abdominis insertional injury, thigh adductor injury, and articular diseases at the pubic symphysis (osteitis pubis).",
author = "Zoga, {Adam C.} and Kavanagh, {Eoin C.} and Omar, {Imran M.} and Morrison, {William B.} and George Koulouris and Hector Lopez and Avneesh Chhabra and John Domesek and Meyers, {William C.}",
year = "2008",
month = "6",
day = "1",
doi = "10.1148/radiol.2473070049",
language = "English (US)",
volume = "247",
pages = "797--807",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "3",

}

TY - JOUR

T1 - Athletic pubalgia and the "sports hernia"

T2 - MR imaging findings

AU - Zoga, Adam C.

AU - Kavanagh, Eoin C.

AU - Omar, Imran M.

AU - Morrison, William B.

AU - Koulouris, George

AU - Lopez, Hector

AU - Chhabra, Avneesh

AU - Domesek, John

AU - Meyers, William C.

PY - 2008/6/1

Y1 - 2008/6/1

N2 - Purpose: To retrospectively determine the sensitivity and specificity of magnetic resonance (MR) imaging findings in patients with clinical athletic pubalgia, with either surgical or physical examination findings as the reference standard. Materials and Methods: Institutional review board approval was granted for this HIPAA-compliant study, and informed consent was waived. MR imaging studies in 141 patients (134 male patients, seven female patients; mean age, 30.1 years; range, 17-71 years) who had been referred to a subspecialist because of groin pain were reviewed for findings including hernia, pubic bone marrow edema, secondary cleft sign, and rectus abdominis and adductor tendon injury. MR imaging findings were compared with surgical findings for 102 patients, physical examination findings for all 141 patients, and MR imaging findings in an asymptomatic control group of 25 men (mean age, 29.8 years; range, 18-39 years). Sensitivity and specificity of MR imaging for rectus abdominis and adductor tendon injury were determined by using a χ2analysis, and significance of the findings was analyzed with an unpaired Student t test. Disease patterns seen at MR imaging were compared with those reported in the surgical and sports medicine literature. Results: One hundred thirty-eight (98%) of 141 patients had findings at MR imaging that could cause groin pain. Compared with surgery, MR imaging had a sensitivity and specificity, respectively, of 68% and 100% for rectus abdominis tendon injury and 86% and 89% for adductor tendon injury. Injury in each of these structures was significantly more common in the patient group than in the control group (P < .001). Only two patients had hernias at surgery. At MR imaging, injury or disease could be fit into distinct groups, including osteitis pubis, adductor compartment injury, rectus abdominis tendon injury, and injury or disease remote from the pubic symphysis. Patients with injury involving the rectus abdominis insertion were most likely to go on to surgical pelvic floor repair. Conclusion: MR imaging depicts patterns of findings in patients with athletic pubalgia, including rectus abdominis insertional injury, thigh adductor injury, and articular diseases at the pubic symphysis (osteitis pubis).

AB - Purpose: To retrospectively determine the sensitivity and specificity of magnetic resonance (MR) imaging findings in patients with clinical athletic pubalgia, with either surgical or physical examination findings as the reference standard. Materials and Methods: Institutional review board approval was granted for this HIPAA-compliant study, and informed consent was waived. MR imaging studies in 141 patients (134 male patients, seven female patients; mean age, 30.1 years; range, 17-71 years) who had been referred to a subspecialist because of groin pain were reviewed for findings including hernia, pubic bone marrow edema, secondary cleft sign, and rectus abdominis and adductor tendon injury. MR imaging findings were compared with surgical findings for 102 patients, physical examination findings for all 141 patients, and MR imaging findings in an asymptomatic control group of 25 men (mean age, 29.8 years; range, 18-39 years). Sensitivity and specificity of MR imaging for rectus abdominis and adductor tendon injury were determined by using a χ2analysis, and significance of the findings was analyzed with an unpaired Student t test. Disease patterns seen at MR imaging were compared with those reported in the surgical and sports medicine literature. Results: One hundred thirty-eight (98%) of 141 patients had findings at MR imaging that could cause groin pain. Compared with surgery, MR imaging had a sensitivity and specificity, respectively, of 68% and 100% for rectus abdominis tendon injury and 86% and 89% for adductor tendon injury. Injury in each of these structures was significantly more common in the patient group than in the control group (P < .001). Only two patients had hernias at surgery. At MR imaging, injury or disease could be fit into distinct groups, including osteitis pubis, adductor compartment injury, rectus abdominis tendon injury, and injury or disease remote from the pubic symphysis. Patients with injury involving the rectus abdominis insertion were most likely to go on to surgical pelvic floor repair. Conclusion: MR imaging depicts patterns of findings in patients with athletic pubalgia, including rectus abdominis insertional injury, thigh adductor injury, and articular diseases at the pubic symphysis (osteitis pubis).

UR - http://www.scopus.com/inward/record.url?scp=45149091555&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=45149091555&partnerID=8YFLogxK

U2 - 10.1148/radiol.2473070049

DO - 10.1148/radiol.2473070049

M3 - Article

VL - 247

SP - 797

EP - 807

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 3

ER -