Learning objectives
The purpose of our educational exhibit is to:
1.
illustrate the basic anatomy and imaging appearance of thigh and pelvic regions;
2.
describe a systematic approach for the evaluation of such structures with magnetic resonance (MR) and dynamic ultrasound (US);
3.
produce anatomical scheme with didactic purpose and show correlation with imaging findings.
Background
The term “pubalgia” is commonly used to identify a groin painful syndrome often observed in amateur and professional athletes who play in sports that need quick acceleration and deceleration,
rapid changes in direction,
kicking and frequent side-to-side movements.
Clinically,
athletes frequently present with insidious unilateral chronic pain (weeks or months) in the inguinal region which may radiate to the scrotum and testicles or to the medial thigh,
at the level of the adductor muscles origin.
This symptoms are typically exacerbated by physical activity; they often...
Findings and procedure details
1.
IMAGING
A combined MR-US approach allows a detailed investigation of the anterior pelvis and groin.
High-resolution ultrasound is an effective technique to accurately identify tendinopathies and muscle tears; in addition,
dynamic evaluation adds several important information about biomechanics of the superficial structures around the pubic symphysis and can be also very helpful to exclude the presence of a true inguinal hernia,
during a valsalva manoeuvre.
The only disvantage of the ultrasound examination is the inability to demonstrate inflammatory and degenerative bony processes.
A high-resolution...
Conclusion
A combined MR-US approach allows a detailed investigation of the anterior pelvis and groin; in addition,
dynamic evaluation adds several important information about biomechanics of such superficial structures.
Knowledge of the basic anatomy and imaging appearance of these structures is essential for the correct assessment of injuries in symptomatic athletes.
References
Omar IM,
Zoga AC,
Kavanagh EC,
Koulouris G,
Bergin D,
Gopez AG,
Morrison WB,
Meyers WC.
Athletic Pubalgia and “Sports Hernia”: Optimal MR Imaging Technique and Findings.
RadioGraphics 2008; 28:1415–1438.
Palisch A,
Zoga AC,
Meyers WC.
Imaging of athletic pubalgia and core muscle injuries: clinical and therapeutic correlations.
Clin Sports Med.
2013 Jul;32(3):427-47.
Davies AG,
Clarke AW,
Gilmore J,
Wotherspoon M,
Connel DA.
Review: imaging of groin pain in the athlete.
Skeletal Radiol (2010) 39:629–644.
Campbell R.
Ultrasound of the athletic groin.
Semin Musculoskelet Radiol....