OCAD MSK

History

M25 professional rugby player with 3 months exercise-related right groin and lateral hip pain of gradual onset

Figure 1 for case Concomitant acetabular labral tear and pubic apophysitis with partial apophyseal separation — Figure 1

Figure 2 for case Concomitant acetabular labral tear and pubic apophysitis with partial apophyseal separation — Figure 2

Discussion

Another example of the strong association between hip and symphyseal pathology. Both pubic apophyses have not yet closed, and the right pubic apophysis shows chronic stress reaction (apophysitis). On US note irregular widening of the right pubic apophyseal growth plate (image 1, solid arrow) and echogenic line of separation (dotted arrow) with normal left side indicated by arrowhead. MRI shows right pubic marrow oedema and adductor brevis oedema, but the apophyseal plate changes are more difficult to appreciate on a study done for hip rather than symphysis. Labral cyst evident on both exams.

Diagnosis

Concomitant acetabular labral tear and pubic apophysitis with partial apophyseal separation

John Read, MD

Courtesy

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