Pediatric Osteitis Pubis

  • Etiology: Non-infectious inflammation of the pubic symphysis which in children is most commonly due to athletic participation
  • Imaging Radiograph: Chronically see subchondral erosive change and joint irregularity and sclerosis which may lead to ankylosis
  • Imaging CT: Chronically see subchondral erosive change and joint irregularity and sclerosis which may lead to ankylosis
  • Imaging MRI: Acutely see inflammation of pubic symphysis – parasymphyseal bone marrow edema and symphyseal fluid and peripubic soft-tissue edema
  • DDX: Osteomyelitis
  • Complications:
  • Treatment: Rest
  • Clinical: Presents with pelvic and or perineal pain

Radiology Cases of Osteitis Pubis

CT and MRI of osteitis pubis
Axial CT with contrast of the pelvis (above and middle) shows a small low density fluid collection with rim enhancement in the midline at the pubic symphysis with surrounding inflammatory change. Axial T2 MRI without contrast of the pelvis (below) shows a focus of high signal intensity in the midline at the pubic symphysis representing the fluid collection with areas of linear high signal intensity posterior and lateral to it representing the surrounding inflammatory change.