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Feb 19th
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MRI Groin Pain

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MRI examination of the left hip demonstrates high signal undermining the origin of the adductor longus (groin) muscle, a common finding seen in athletes presenting with groin pain. This is an injury often associated with osteitis pubis (OP).

Images through the groin demonstrates an area of increased signal in keeping with the diagnosis of a partial thickness tear at the origin of the adductor muscle (adductor longus) as it arises of the pubic bone.  This is a specific finding on MRI that well correlates with the clinical findings of pain on the same side [1].

Similar hyperintensity may also been seen in the adjacent muscle as well as bone in keeping with increased fluid (oedema).  The presence of oedema in the marrow of the pubic bone is the hallmark finding of the diagnosis of osteitis pubis, commonly referred to as “OP” [2].

Interestingly, patients with groin pain will often have changes of early arthritis of the hip, which is seen as loss of cartilage and small cysts in the bone marrow.  It is thought that the decreased range of motion in the hip, specifically internal and external rotation [3], results in additional stress on the pubic bone and therefore predispose such patients to developing osteitis pubis.




  1. Brennan D, O'Connell MJ, Ryan M, Cunningham P, Taylor D, Cronin C, O'Neill P, Eustace S.  Secondary cleft sign as a marker of injury in athletes with groin pain: MR image appearance and interpretation. Radiology 235(1):162-7, 2005
  2. Verrall GM, Henry L, Fazzalari NL, Slavotinek JP, Oakeshott RD.  Bone biopsy of the parasymphyseal pubic bone region in athletes with chronic groin injury demonstrates new woven bone formation consistent with a diagnosis of pubic bone stress injury. Am J Sports Med 36(12):2425-31, 2008
  3. Verrall GM, Hamilton IA, Slavotinek JP, Oakeshott RD, Spriggins AJ, Barnes PG, Fon GT.  Hip joint range of motion reduction in sports-related chronic groin injury diagnosed as pubic bone stress injury. J Sci Med Sport. 2005 Mar;8(1):77-84.
  4. Verrall GM, Slavotinek JP, Barnes PG, Esterman A, Oakeshott RD, Spriggins AJ.  Hip joint range of motion restriction precedes athletic chronic groin injury. J Sci Med Sport 10(6):463-6, 2007
  5. Koulouris G.   Imaging review of groin pain in elite athletes: an anatomic approach to imaging findings. AJR Am J Roentgenol 191(4):962-72, 2008
  6. Zoga AC, Kavanagh EC, Omar IM, Morrison WB, Koulouris G, Lopez H, Chaabra A, Domesek J, Meyers WC. Athletic pubalgia and the "sports hernia": MR imaging findings. Radiology 247(3):797-807, 2008
  7. 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 28(5):1415-38, 2008

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Last Updated ( Thursday, 03 July 2014 22:25 )  
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