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Focal osteopenia of pubic parasymphyseal bone as an underlying cause of groin pain in sports: a new perspective
  1. Alexandra Dimitrakopoulou1,2,
  2. Ernest Schilders1,2
  1. 1London Hip Arthroscopy Centre at The Wellington Hospital and Fortius Clinic, London, UK
  2. 2Carnegie Faculty of Sports, Leeds Beckett University, Leeds, UK
  1. Correspondence to Alexandra Dimitrakopoulou, alexdimitr{at}


Groin pain is a common problem in athletes. The diagnosis can be difficult because of the complexity of the groin anatomy, the numerous clinical entities presenting with similar symptoms, the concurrence of those entities and the confusing terminology. Thus, a dilemma in diagnosis may arise leading to long-standing symptoms, disabling groin pain, mismanagement and therefore to poor treatment. Hereby, we present such a case of a recreational athlete complaining for excruciate pubic pain after being misdiagnosed and subsequently mistreated affecting her quality of life. We report on a new interesting finding, the focal osteopenia over the pubic parasymphyseal bone, together with administration of bisphosphonates for first time, as a treatment, for this condition in this body area. Our purpose is to shed light on the pathomechanism of groin pain labelled as osteitis pubis. We also outline the importance of thorough history and physical examination combined with appropriate advanced imaging.

  • osteoporosis
  • musculoskeletal and joint disorders
  • calcium and bone
  • orthopaedics
  • groin pain
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  • Contributors Both authors have contributed to the planning, conduct, reporting conception and design, acquisition, analysis and interpretation of the work described in the article.

  • 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.

  • Patient consent Obtained.

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

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