{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T12:23:18Z","timestamp":1776860598878,"version":"3.51.2"},"reference-count":24,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,4,9]]},"abstract":"<jats:p>Groin pain is a common problem in athletes. The diagnosis can be difficult because of the complexity of the groin anatomy, the numerous clinical entities presenting with similar symptoms, the concurrence of those entities and the confusing terminology. Thus, a dilemma in diagnosis may arise leading to long-standing symptoms, disabling groin pain, mismanagement and therefore to poor treatment. Hereby, we present such a case of a recreational athlete complaining for excruciate pubic pain after being misdiagnosed and subsequently mistreated affecting her quality of life. We report on a new interesting finding, the focal osteopenia over the pubic parasymphyseal bone, together with administration of bisphosphonates for first time, as a treatment, for this condition in this body area. Our purpose is to shed light on the pathomechanism of groin pain labelled as osteitis pubis. We also outline the importance of thorough history and physical examination combined with appropriate advanced imaging.<\/jats:p>","DOI":"10.1136\/bcr-2017-223698","type":"journal-article","created":{"date-parts":[[2018,5,4]],"date-time":"2018-05-04T06:10:28Z","timestamp":1525414228000},"page":"bcr-2017-223698","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Focal osteopenia of pubic parasymphyseal bone as an underlying cause of groin pain in sports: a new perspective"],"prefix":"10.1136","volume":"2018","author":[{"given":"Alexandra","family":"Dimitrakopoulou","sequence":"first","affiliation":[{"name":"London Hip Arthroscopy Centre at The Wellington Hospital and Fortius Clinic, London, UK"},{"name":"Carnegie Faculty of Sports, Leeds Beckett University, Leeds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernest","family":"Schilders","sequence":"additional","affiliation":[{"name":"London Hip Arthroscopy Centre at The Wellington Hospital and Fortius Clinic, London, UK"},{"name":"Carnegie Faculty of Sports, Leeds Beckett University, Leeds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,5,4]]},"reference":[{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.1","doi-asserted-by":"publisher","DOI":"10.1093\/jhps\/hnv083"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.06.0051"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.3","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092627"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.4","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.F.00567"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.5","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.01675"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.6","doi-asserted-by":"crossref","first-page":"361","DOI":"10.2165\/11586820-000000000-00000","article-title":"Athletic osteitis pubis","volume":"41","author":"Hiti","year":"2011","journal-title":"Sports Med"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.7","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2008.050989"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.8","doi-asserted-by":"publisher","DOI":"10.1007\/s11932-003-0020-7"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.9","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507306160"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.10","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508324690"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.11","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-004-0753-2"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.12","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2009.062554"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.13","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1097\/JSA.0000000000000083","article-title":"Core muscle injury\/sports hernia\/athletic pubalgia, and femoroacetabular impingement","volume":"23","author":"Ross","year":"2015","journal-title":"Sports Med Arthrosc Rev"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.14","doi-asserted-by":"publisher","DOI":"10.1053\/j.otsm.2004.09.011"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.15","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-199112040-00005"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.16","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1249\/00005768-199505000-00003","article-title":"Osteitis pubis in collegiate football players","volume":"27","author":"Batt","year":"1995","journal-title":"Med Sci Sports Exerc"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.17","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1177\/03635465000280011501","article-title":"Management of severe lower abdominal or inguinal pain in high-performance athletes","volume":"28","author":"Meyers","year":"2000","journal-title":"Am J Sports Med"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.18","doi-asserted-by":"publisher","DOI":"10.1080\/02640410310001655804"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7580.2006.00540.x"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.20","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0b013e318164f40b"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.21","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.0070614"},{"key":"2025082801294894000_2018.may03_1.bcr-2017-223698.22","doi-asserted-by":"crossref","unstructured":"Kini U , Nandeesh BN . 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