ABSTRACT
Magnetic resonance (MR) imaging technique and findings in the setting of athletic pubalgia, including injury at the rectus abdominis/adductor aponeurosis, are becoming widely recognized. A subset of these patients is treated with various pelvic floor repairs, mesh reinforcements, and tendon releases. Most of these patients do well after intervention, but some have persistent or refractory groin pain, and others eventually develop new injuries in the pubic region or elsewhere about the pelvic girdle. This review describes the expected and some unexpected MRI findings in patients with recurrent or persistent groin pain after a “sports hernia” repair.
KEYWORDS
MRI - athletic pubalgia - groin injury
REFERENCES
-
1 Zoga A C, Morrison W B, Roth C G, Horner M, Meyers W C. MR findings in athletic pubalgia: normal postoperative appearance and reinjury patterns after pelvic repair and releases for ‘sports hernia’. Paper presented at: The 96th Annual Meeting of the Radiological Society of North America; December 2009; Chicago, IL
-
2
Meyers W C, Kahan D M, Joseph T et al..
A current analysis of women athletes with pelvic pain.
Med Sci Sports Exerc.
2011;
January 21 (Epub ahead of print)
-
3
Meyers W C, McKechnie A, Philippon M J, Horner M A, Zoga A C, Devon O N.
Experience with “sports hernia” spanning two decades.
Ann Surg.
2008;
248
(4)
656-665
-
4
Zoga A C, Mullens F E, Meyers W C.
The spectrum of MR imaging in athletic pubalgia.
Radiol Clin North Am.
2010;
48
(6)
1179-1197
-
5
Meyers W C, Foley D P, Garrett W E, Lohnes J H, Mandlebaum B R. PAIN (Performing Athletes with Abdominal or Inguinal Neuromuscular Pain Study Group) .
Management of severe lower abdominal or inguinal pain in high-performance athletes.
Am J Sports Med.
2000;
28
(1)
2-8
-
6
Garvey J F, Read J W, Turner A.
Sportsman hernia: what can we do?.
Hernia.
2010;
14
(1)
17-25
-
7
Ziprin P, Prabhudesai S G, Abrahams S, Chadwick S J.
Transabdominal preperitoneal laparoscopic approach for the treatment of sportsman's hernia.
J Laparoendosc Adv Surg Tech A.
2008;
18
(5)
669-672
-
8
Zoga A C, Kavanagh E C, Omar I M et al..
Athletic pubalgia and the “sports hernia”: MR imaging findings.
Radiology.
2008;
247
(3)
797-807
-
9
Caudill P, Nyland J, Smith C, Yerasimides J, Lach J.
Sports hernias: a systematic literature review.
Br J Sports Med.
2008;
42
(12)
954-964
-
10
Omar I M, Zoga A C, Kavanagh E C et al..
Athletic pubalgia and “sports hernia”: optimal MR imaging technique and findings.
Radiographics.
2008;
28
(5)
1415-1438
-
11
Robinson P, Barron D A, Parsons W, Grainger A J, Schilders E M, O'Connor P J.
Adductor-related groin pain in athletes: correlation of MR imaging with clinical findings.
Skeletal Radiol.
2004;
33
(8)
451-457
-
12
Kunduracioglu B, Yilmaz C, Yorubulut M, Kudas S.
Magnetic resonance findings of osteitis pubis.
J Magn Reson Imaging.
2007;
25
(3)
535-539
-
13
Brennan D, O'Connell M J, Ryan M et al..
Secondary cleft sign as a marker of injury in athletes with groin pain: MR image appearance and interpretation.
Radiology.
2005;
235
(1)
162-167
-
14
Shortt C P, Zoga A C, Kavanagh E C, Meyers W C.
Anatomy, pathology, and MRI findings in the sports hernia.
Semin Musculoskelet Radiol.
2008;
12
(1)
54-61
-
15
Robinson P, Barron D A, Parsons W, Grainger A J, Schilders E M, O'Connor P J.
Adductor-related groin pain in athletes: correlation of MR imaging with clinical findings.
Skeletal Radiol.
2004;
33
(8)
451-457
-
16
Cunningham P M, Brennan D, O'Connell M, MacMahon P, O'Neill P, Eustace S.
Patterns of bone and soft-tissue injury at the symphysis pubis in soccer players: observations at MRI.
AJR Am J Roentgenol.
2007;
188
(3)
W291-6
-
17
Zajick D C, Zoga A C, Omar I M, Meyers W C.
Spectrum of MRI findings in clinical athletic pubalgia.
Semin Musculoskelet Radiol.
2008;
12
(1)
3-12
-
18
Blankenbaker D G, Tuite M J.
The painful hip: new concepts.
Skeletal Radiol.
2006;
35
(6)
352-370
-
19 Zoga A C, Shortt C P, Morrison W B, Devon O N, Meyers W C. MRI of athletic pubalgia: incidence and imaging of concomitant pubic symphysis and ipsilateral hip pathology. Paper presented at: The 95th Annual Meeting of the Radiological Society of North America; December 2008; Chicago, IL
-
20
Kavanagh E C, Koulouris G, Ford S, McMahon P, Johnson C, Eustace S J.
MR imaging of groin pain in the athlete.
Semin Musculoskelet Radiol.
2006;
10
(3)
197-207
-
21
Brittenden J, Robinson P.
Imaging of pelvic injuries in athletes.
Br J Radiol.
2005;
78
(929)
457-468
Adam C ZogaM.D.
Department of Radiology, Thomas Jefferson University Hospital
132 South 10th St., Ste. 1083A, Philadelphia, PA 19107
Email: adam.zoga@jefferson.edu
