Athletic Pubalgia MRI: Sports Groin & the Pubic Plate
Chronic groin pain in athletes has many overlapping causes. MRI is the one test that surveys them together and pinpoints the pubic plate, the crux of “sports hernia.”
What “sports groin” really is
Athletic pubalgia (“sports hernia”, though it isn’t a true hernia) centres on injury to the rectus abdominis–adductor longus aponeurosis and its attachment to the pubis (the pubic plate) from repetitive kicking/twisting loads.
A dedicated large-field pelvic protocol (including oblique-axial planes along the aponeurosis) is needed; a standard hip MRI can miss the pubic-plate lesion.
Key findings
- Rectus/adductor aponeurosis injury: disruption/detachment at the pubis.
- Secondary cleft sign: fluid tracking from the symphysis, a marker of aponeurotic injury.
- Osteitis pubis: subchondral bone-marrow oedema and symphyseal degeneration.
- Adductor pathology: tendinopathy/tears at the origin.
Why survey wide
Groin pain can also be hip (FAI, labral tear), true inguinal/femoral hernia, stress fracture, or referred, and several often coexist. MRI assesses these in one study, guiding whether treatment is conservative, targeted injection, or surgery.
Sources
- Zoga AC et al. Athletic pubalgia and the “sports hernia”: MR imaging findings. Radiology 2008;247:797–807.
Educational summary for clinicians; correlate with sports-medicine assessment. Not medical advice.
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