Q: What is Ostetis Pubis?
A: Ostetis pubis is a painful inflammation of the symphysis pubis. Its exact cause is not known, but infection is not likely. It can be caused by trauma, rheumatologic disorders (arthritis etc), pregnancy, or high intensity exercise.
Athletes with ostetis pubis often complain of pain in the symphysis pubis area, tenderness to palpation over the symphysis, and pain in the pubic area with pressure on the iliac wing in the lateral decubitus position (lateral compression test).
Often it is difficult to distinguish ostetis pubis from chronic hip adductor tendinitis, tendon injuries, fractures, bursitis, hernias,osteomyelitis, or referred pain. The lateral compression test may help. In additon, Xrays may show bilateral symphysis pubis osteophytes, sclerosis, and widening. MRI or bone-scan may help in difficult cases.
Q: How can Ostetis Pubis be treated?
A: Almost all cases will resolve spontaneously (90-95%). Usually, a physician will recommend anti-inflammatory mediciations, physiotherapy, and possibly local steroid injections. Physiotherapy usually consists of adductor stretching and strengthening.
If pain persists, there are three surgical options:
Wedge Resection of the Symphysis: this may lead to improvement of symptoms, but leaves the athlete at risk for pelvic instability. This may necessitate further surger for stabilization at a later date.
Arthrodesis of the Symphysis: here the symphysis is immobilized by resecting the cartilage and using plates or bone grafts. This ofter requires a long recovery time.
Symphyseal Curettage: Curettage of the symphysis with injection of steroids may take place as a day surgery, and may be helpful