PubMint: causes and treatment - NetDoctor - Diseases - 2021

Osteitis pubis


A Osteitis pubis (Osteitis pubis) is a painful non-infectious inflammation of the pubic symphysis, pubic bone and immediate surrounding structures. The cause is usually repeated microtrauma caused by faulty or overloaded. Above all, athletes, especially footballers, are affected. Find out more about the pubic bone infection here.

ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. M85ArtikelübersichtSchambeinentzündung

  • description
  • symptoms
  • Causes and risk factors
  • Examinations and diagnosis
  • treatment
  • Disease course and prognosis

Pubic bone inflammation: description

Pubic bone inflammation is a non-infectious inflammation of the pubic symphysis, pubic bone and the immediate surrounding structures. It is referred to in the jargon as Osteitis pubis, Symphysenosteitis or Pubalgia (Pubalgia).

The pubic inflammation especially affects athletes. Every year, about 0.5 to 7 percent of athletes suffer from pubic bone inflammation - especially footballers, but also other athletes such as basketball players and tennis players. Above all, men are affected in the average age of 30 years. Women who develop pubic bone infection are on average around 35 years old. For the patients, the illness may mean that they have to give up any sporting activity in the longer term.

Pubic bone inflammation: what is the pubis?

The bony pelvis consists of the sacrum and the two hipbones. Each hip bone is in turn made up of three parts: pubis, ilium and ischium.

The two pubic bones form the front part of the bony pelvis. They are connected by a fibrocartilaginous connection, the pubic symphysis (symphysis). This keeps the pelvic ring together and at the same time allows the pubic bones to shift by a few millimeters.

When standing on two legs, the load of the trunk is transferred from the spine to the legs. This pulling forces act on the symphysis. When standing on one leg or while walking, the pressure on the symphysis increases, because in addition to weight from the leg added.

In pregnant women, the released hormone relaxin makes the symphysis more mobile. This allows the child to emerge more easily through the bony pelvis at birth.

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Pubic: symptoms

An important symptom of pubic bone inflammation is pain in the area of ​​the symphysis and the pubic rami. They can be so strong that sufferers have to restrict or even refrain from sporting activities. The symphysis is clearly tender-painful; the surrounding area is partially swollen.

Sometimes the pain of a pubic bone infection is not limited to the symphysis and the pubic rami, but radiates into the groin, hip or perineal region. Pain in the lower abdomen and around the pelvic floor is also possible.

Typical of pubic inflammation is also the "onset pain". The pain is strongest when you get up after a long period of sitting and relax in uniform movements like walking. Jerky movements or climbing stairs cause the sufferer usually pain. If sport is still possible, the pain often only appears after the end of the physical stress or intensifies toward evening.

Fever is more typical of bacterial infections and absent in pubic bone inflammation.

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PubMal inflammation: causes and risk factors

If the symphysis is stressed too much, it can lead to inflammation and the formation of scar tissue. Under certain circumstances, this can lead to the bone being broken down and cysts or stress fractures (stress-related fractures) to develop in adjacent bone regions.

Pubic inflammation is especially common in sports where high tractive forces are acting on the symphysis. These include sports with many sprint and shot elements or quick changes of direction. As risk sports for pubic inflammation, the following apply:

  • Soccer
  • American football
  • basketball
  • tennis
  • Running sports

Pregnancy and childbirth can also be the cause of a pubic bone infection. In one study, bleeding in the symphysis and adjacent bone was detected in women after birth. There were also cracks in the cartilage. Whether this mechanism also happens in athletes with pubic bone inflammation, can not say for sure.

Furthermore, in rare cases, pubic inflammation may be a complication of pelvic surgery. These include, for example, prostate surgery. Even when inserting a bladder catheter, which is inserted above the pubis through the abdominal wall into the bladder (suprapubic urinary catheter), a pubic bone infection can develop as a result.

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PubMal inflammation: examinations and diagnosis

The diagnosis of pubic inflammation is not easy. The described pain can also occur in other sports injuries and illnesses. So initially, usually a groin strain, an adductor syndrome (overloading of certain tendons) or other painful diseases in the groin is suspected. Also, the hip joint is often suspected as a cause of pain. Overall, it is important to differentiate a pubic bone inflammation against the following diseases and injuries with similar symptoms:

  • Bone marrow inflammation (osteomyelitis)
  • Stress / fatigue fractures in the pelvic bone area
  • Demolition fractures of tendon attachments
  • Inguinal hernias
  • Nerve entrapment syndromes
  • Insertion dendinosis (chronic irritation of a tendon attachment to the bone)
  • Adductor strain (adductors = muscles on the inner thigh)
  • Diseases of the urinary and genital tract
  • Rheumatological diseases
  • Neoplasms (neoplasms of tissue)

PubMal inflammation: anamnesis

To get to the bottom of the cause of the complaint, the doctor will first take the medical history (anamnesis) by talking at length to the patient. Possible questions include: