bone destruction. Tuberculosis septic arthritis runs a more chronic course and is generally less painful than suppurative osteomyelitis.2 Typical is associated constitutional symptoms include fever, chills, and malaise. If an infection is suspected, the workup should include a PPD (purified protein derivative) test, laboratory studies (blood cultures, CBC, ESR, CRP), and a CT-guided needle biopsy of the pubic symph-ysis obtained before beginning empiric antibiotic therapy.3 Inflammatory diseases such as ankylosing spondylitis and Reiter's syndrome may also manifest, although infrequently, with pubic symphysis destructions. Metabolic diseases capable of producing osseous irregularities and bone resorption of the pubic sym-physis include renal osteodystrophy and hyper-parathyroidism. Osteoarthritic degeneration of the pubic symphysis associated with normal physiologic aging has been well detailed.39 Last, benign and malignant skeletal tumors are rare but must be considered in cases of chronic unresponsive pain with radiographic changes of the pubic symphysis. The destructive changes will not only involve the pubic sym-physis but also extend into the pubic rami. The MRI and CT scan help define the bony and soft tissue structures around these lesions effectively. In addition, abnormal serum alkaline phosphate and calcium levels suggest a neoplastic process.


The treatment of athletic osteitis pubis can be tremendously challenging. Treatment begins with immediate patient education, activity modification, and rest. A drawn-out clinical course is frequently seen,

TABLE 5.2. Salient Clinical Features Between Osteomyelitis Pubis and Athletic Osteitis Pubis.

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Thank you for deciding to learn more about the disorder, Osteoarthritis. Inside these pages, you will learn what it is, who is most at risk for developing it, what causes it, and some treatment plans to help those that do have it feel better. While there is no definitive “cure” for Osteoarthritis, there are ways in which individuals can improve their quality of life and change the discomfort level to one that can be tolerated on a daily basis.

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