Ischiopubic synchondrosis as a case of non specific groin pain in a 12 year old football player

Abstract

A 12 year old football player presented with non specific groin pain at the ischiopubic synchondrosis (IPS). IPS is the temporary junction between the inferior ischial and pubic branch, which obliterates before puberty during skeletal maturation. As a consequence to asymmetric mechanical stress, unilateral IPS stress reaction typically occurs at the non-dominant leg of prepubescent athletes. On conventional radiography, the tumor-like lesion at the IPS can become a diagnostic challenge. A typical MRI feature defined as “fibrous bridging”, as well as patient’s history, age and other characteristics can be helpful in the differential diagnosis of non-pathologic IPS stress reactions. Chronic groin pain in young athletes needs further investigation. However, it is important to acknowledge the non-pathologic condition of IPS, and invasive diagnostic examination and therapy should be avoided at all time. Based on this clinical case, we emphasize the diagnostic work up and conservative management of IPS.