Abstract
Objective To compare the accuracy of ultrasound (US) with that of magnetic resonance imaging
(MRI) in the detection of aponeurosis lesions of the rectus abdominis/adductor longus
muscles, to study the characteristics of the athletes and imaging findings associated
with pubalgia, and to demonstrate the importance of each method in evaluating this
condition.
Materials and methods The present study was conducted from 2011 to 2016 with 39 professional soccer players:
15 with pubalgia and 24 without pubalgia. Age, field position, body mass index (BMI),
weekly training load, career length, and history of thigh/knee injury and lower back
pain were recorded. The following tests were performed: radiographs (anteroposterior
view of the pelvis in standing and flamingo positions) to evaluate hip impingement,
sacroiliac joint, and pubic symphysis instability; US to analyze the common aponeurosis
of the rectus abdominis/adductor longus muscles and inguinal hernias; and MRI for
pubic bone degenerative alterations and edema, and lesions in the adductor and rectus
abdominis muscles and their aponeurosis.
Results There was an association between pubalgia, high BMI (p = 0.032) and muscle alterations (p < 0.001). Two patients with pubalgia had inguinal hernias and one patient with pubalgia
and two controls had sports hernias. Pubic degenerative changes were frequent in both
groups. Aponeurosis lesions were more frequent in patients with pain. The US detection
had 44.4% sensitivity and 100% specificity.
Conclusion The evaluation of athletic pubalgia should be performed with radiography, US, and
MRI. High BMI, muscle injuries, geodes, and osteophytes are findings associated with
pubalgia; US has low sensitivity to detect injuries of the common aponeurosis of the
rectus abdominis/adductor longus muscles.
Keywords
magnetic resonance imaging/methods - pubic symphysis/diagnostic imaging - pubic symphysis/injuries
- groin - radiography - athletic injuries/pathology - ultrasonography
