"Athletic Pubalgia and “Sports Hernia”: Optimal MR Imaging Technique and Findings"
September 2008 RadioGraphics, 28, 1415-1438.
Updated Diagnosis November 2009
--Rectus Abdominis-Adductor Aponeurotic Plate Injury/Disruption/Tear (RAAPT)
Spectrum Of Groin Pain in Athletes (September 2008 RadioGraphics, 28, 1415-1438):
1. RAAAPT -- a. tear 1-2cm lateral to public symphsis best seen on axial and saggital fluid sensitive seq.
b. Other findings: abnormal marrow signal isolated to the anterior-inferior aspect of the pubic body and deep to the rectus abdominis–adductor aponeurotic attachment; secondary cleft sign - apparent inferior extension of the central symphyseal fibrocartilaginous cleft along the anteroinferior margin of the pubic body"
2. Adductor Tendinosis, Tenoperiostitis and Tear
3. Osteitis Pubis -- "diffuse marrow edema extending from the subchondral plate and often involving both pubic bodies . In addition, periostitis, articular surface irregularity, erosions, anterior and posterior osteophytes, and subchondral cysts may be seen on MR images. A secondary cleft sign is commonly present. The myotendinous attachments are preserved unless there is coexistent tendinopathy. Unlike the marrow edema in rectus–adductor aponeurotic injuries, which is confined to the anterior subcortical bone, the marrow edema in osteitis pubis extends across the entire anteroposterior dimension of the pubic body.
4. Hockie Goalie Baseball Pitcher Syndrome -- epimysial or myofascial herniation of the adductor longus muscle belly several centimeters away from the site of its pubic attachment.
5. Pubic Stress Fractures
6. Septic Arthritis osteomyeltis
7. Labral tear
8. Snapping Hip Syndrome
9. Inguinal Hernia
10. Osteoid Osteoma
11. Nerve Entrapment Syndromes
12. Apophysitis
Updated Diagnosis November 2009
--Rectus Abdominis-Adductor Aponeurotic Plate Injury/Disruption/Tear (RAAPT)
Spectrum Of Groin Pain in Athletes (September 2008 RadioGraphics, 28, 1415-1438):
1. RAAAPT -- a. tear 1-2cm lateral to public symphsis best seen on axial and saggital fluid sensitive seq.
b. Other findings: abnormal marrow signal isolated to the anterior-inferior aspect of the pubic body and deep to the rectus abdominis–adductor aponeurotic attachment; secondary cleft sign - apparent inferior extension of the central symphyseal fibrocartilaginous cleft along the anteroinferior margin of the pubic body"
2. Adductor Tendinosis, Tenoperiostitis and Tear
3. Osteitis Pubis -- "diffuse marrow edema extending from the subchondral plate and often involving both pubic bodies . In addition, periostitis, articular surface irregularity, erosions, anterior and posterior osteophytes, and subchondral cysts may be seen on MR images. A secondary cleft sign is commonly present. The myotendinous attachments are preserved unless there is coexistent tendinopathy. Unlike the marrow edema in rectus–adductor aponeurotic injuries, which is confined to the anterior subcortical bone, the marrow edema in osteitis pubis extends across the entire anteroposterior dimension of the pubic body.
4. Hockie Goalie Baseball Pitcher Syndrome -- epimysial or myofascial herniation of the adductor longus muscle belly several centimeters away from the site of its pubic attachment.
5. Pubic Stress Fractures
6. Septic Arthritis osteomyeltis
7. Labral tear
8. Snapping Hip Syndrome
9. Inguinal Hernia
10. Osteoid Osteoma
11. Nerve Entrapment Syndromes
12. Apophysitis
