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

American Journal of Sports Medicine

Volumn 36, Issue 12, 2008, Pages 2425-2431

  Verrall, Geoffrey M ^a,b   Henry, Lachlan ^a   Fazzalari, Nicola L ^a   Slavotinek, John P ^a   Oakeshott, Roger D ^a  

^a FLINDERS MEDICAL CENTRE   (Australia)

^b Sportsmed SA   (Australia)

Author keywords

Athlete; Bone biopsy; Chronic groin injury; Histology; Magnetic resonance imaging; Pubic bone stress injury

Indexed keywords

HEMOSIDERIN;

ABDOMINAL INJURY; ADULT; ARTICLE; ATHLETE; BONE BIOPSY; BONE INJURY; BONE MARROW; BONE NECROSIS; BONE STRESS; BONE STRUCTURE; BONE TISSUE; CALLUS; CHRONIC DISEASE; CHRONIC GROIN INJURY; CLINICAL ARTICLE; CRITERION VARIABLE; DESMOID TUMOR; EDEMA; FIBROBLAST; HISTOLOGY; HUMAN; HUMAN TISSUE; INFLAMMATION; INGUINAL REGION; MALE; NEOVASCULARIZATION (PATHOLOGY); NUCLEAR MAGNETIC RESONANCE IMAGING; OSSIFICATION; OSTEOBLAST; PAIN; PRIORITY JOURNAL; PUBIC BONE; PUBIC BONE STRESS INJURY; PUBIS SYMPHYSIS; RADIATION DOSE DISTRIBUTION; SIGNAL TRANSDUCTION; STELLATE CELL; WOVEN BONE;

ATHLETIC INJURIES; BIOPSY; CHRONIC DISEASE; FRACTURES, STRESS; GROIN; HUMANS; MAGNETIC RESONANCE IMAGING; MALE; PUBIC BONE;

EID: 56249141808     PISSN: 03635465     EISSN: 15523365     Source Type: Journal    
DOI: 10.1177/0363546508324690     Document Type: Article

References (21)

1. Alderink GJ The sacroiliac joint: review of anatomy, mechanics and function. J Orthop Sports Phys Ther. 1991 ; 13: 71-84.
2. Anderson MW, Greenspan A. Stress fractures. Radiology. 1996 ; 199: 1-12.
3. Cunningham PM, Brennan D., O'Connell M., MacMahon P., O'Neill P., Eustace S. Patterns of bone and soft-tissue injury at the pubic symphysis in soccer players: observations at MRI. Am J Roentgenol. 2007 ; 188: W291 - W296.
4. Deutsch AL, Coel MN, Mink JH Imaging of stress injuries to bone: radiography, scintigraphy and MR imaging. Clin Sports Med. 1997 ; 16: 275-290.
5. Ekberg O., Sjoberg S., Westlin N. Sports-related groin pain: evaluation with MR imaging. Eur Radiol. 1996 ; 6: 52-55.
6. Fricker P., Traunton J., Ammann W. Osteitis pubis in athletes: infection, inflammation or injury? Sports Med. 1991 ; 12: 266-279.
7. Holmich P., Uhrskov P., Ulnits L., et al. Effectiveness of active physical training as treatment for long standing adductor-related groin pain in athletes: randomised trial. Lancet. 1999 ; 353: 439-443.
8. Hungerford DS, Jones LC Asymptomatic osteonecrosis: should it be treated ? Clin Orthop Relat Res. 2004: 429: 124-130.
9. Lavignolle B., Vital JM, Senegas J., et al. An approach to the functional anatomy of the sacroiliac joints in vivo. Anat Clin. 1982 ; 5: 169-176.
10. Lovell G. The diagnosis of chronic groin pain in athletes: a review of 189 cases. Aust J Sci Med Sport. 1995 ; 27: 76-79.
11. Lovell G., Galloway H., Hopkins W., Harvey A. Osteitis pubis and assessment of bone marrow edema at the pubic symphysis with MRI in an elite junior male soccer squad. Clin J Sport Med. 2006 ; 16: 117-122.
12. Matsuzaki H., Wohl GR, Novack DV, Lynch JA, Silva MJ Damaging fatigue loading stimulates increases in periosteal vascularity at sites of bone formation in the rat ulna. Calcif Tissue Int. 2007 ; 80: 391-399.
13. Plenk H. Jr, Hofmann S., Eschberger J., et al. Histomorphology and bone morphometry of the bone marrow edema syndrome of the hip. Clin Orthop Relat Res. 1997 ; 334: 73-84.
14. Rangger C., Kathrein A., Freund MC, Klestil T., Kreczy A. Bone bruise of the knee: histology and cryosections in 5 cases. Acta Orthop Scand. 1998 ; 69: 291-294.
15. Robinson P., Barron DA, Parsons W., Grainger AJ, Schilders EM, O'Connor PJ Adductor-related groin pain in athletes: correlation of MR imaging with clinical findings. Skeletal Radiol. 2004 ; 33: 451-457.
16. Silva MJ, Touhey DC Bone formation after damaging in vivo fatigue loading results in recovery of whole-bone monotonic strength and increased fatigue life. J Orthop Res. 2007 ; 25: 252-261.
17. Slavotinek JP, Verrall GM, Fon GT, Sage MR Groin pain in footballers: the association between pre-season clinical and pubic bone MRI findings and athlete outcome. Am J Sports Med. 2005 ; 33: 894-899.
18. Uthgenannt BA, Kramer MH, Hwu JA, Wopenka B., Silva MJ Skeletal self-repair: stress fracture healing by rapid formation and densification of woven bone. J Bone Miner Res. 2007 ; 22: 1548-1556.
19. Verrall GM, Hamilton IA, Slavotinek JP, et al. Hip joint range of motion reduction in sports-related chronic groin injury diagnosed as pubic bone stress injury. J Sci Med Sport. 2005 ; 8: 77-84.
20. Verrall GM, Slavotinek JP, Fon GT Incidence of bone marrow oedema in Australian Rules football players: relation to groin pain. Br J Sports Med. 2001 ; 35: 28-33.
21. Verrall GM, Slavotinek JP, Fon GT, Barnes PG: Outcome of conservative management of athletic chronic groin injury diagnosed as pubic bone stress injury. Am J Sports Med. 2007 ; 35: 467-474.