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Pubic symphysis osteomyelitis with associated vesico-symphyseal fistula: a difficult diagnosis
  1. Brendan Wechsler1,
  2. Jonah Devries1 and
  3. Douglas Yim2
  1. 1Medical Student Affairs, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA
  2. 2Interventional Radiology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
  1. Correspondence to Brendan Wechsler; brendan.wechsler{at}


Pubic symphysis osteomyelitis is an infectious complication that rarely arises in men who have undergone treatment for prostate cancer. This process may more rarely arise from a fistulous tract between the pubic symphysis and the urinary tract. In this case report, we discuss the most common clinical presentations and laboratory findings that lead to the diagnosis of this disease process, as well as the role of MRI and other imaging modalities in confirmation of the diagnosis. This case serves as a reminder to clinicians to have earlier consideration of pubic symphysis osteomyelitis in their differential diagnosis to reduce the risk of long-term complications associated with undertreatment.

  • radiology
  • urology

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  • Contributors BW helped to combine all elements of the paper and write the main components, including the abstract, introduction and discussion. He also obtained the patient consent form and aided in obtaining images relevant to the case. DY conceived the idea of presenting the patient presentation as a case report, and helped with redirection of certain elements within the paper, as well as proofreading and providing edits along the way. JD helped to describe the patient presentation as a case write-up. He also helped with the literature review and provided aid with resources, as well as obtaining and editing relevant images. All authors contributed to the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.