Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

41. Right Inguinal Hernia with Osteitis Pubis…
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Workup
Magnetic resonance imaging ( MRI) of the osseous pelvis with attention
to the pubic symphysis showed that there was mild marrow edema
and subchondral remodeling at the pubic symphysis compatible with
osteitis pubis (Fig. 41.1 ). The adductor tendons were intact. The rectus
abdominis aponeurosis was intact as well. There was also a fat-containing
right-sided inguinal hernia with direct and indirect component measuring
3 cm (Fig. 41.2 ).
Diagnosis
While the reducible right inguinal hernia in this patient was obvious,
the patient’s history and physical examination gave high suspicion for
the clinical diagnosis of osteitis pubis as well. The symptoms of osteitis
pubis can be presented as any complaint in the groin or lower abdomen
[ 1 ]. Pain generally is localized over the symphysis and may radiate to
the groin, scrotum, perineum, medial thigh, hip, or abdomen [ 2 ].
Fig. 41.1. Osteitis pubalgia on MRI.