title: Grading scale of radiographic findings in the pubic bone and symphysis in athletes.
abstract: OBJECTIVE
  Radiographic abnormalities in the pubic bone and symphysis are often seen in athletes with groin pain. The aim was to create a grading scale of such radiologic changes.
  
  
  METHODS
  Plain radiography of the pelvic ring including the pubic bone and the symphysis was performed in 20 male athletes, age 19-35, with long-standing uni- or bilateral groin pain. We used two control groups: Control group 1: 20 healthy age-matched men who had undergone radiologic examination of the pelvis due to trauma. Control group 2: 120 adults (66 men and 54 women) in 9 age groups between 15 and 90 years of age. These examinations were also evaluated for interobserver variance.
  
  
  CONCLUSIONS
  The grading scale was based on the type and the amount of the different changes, which were classified as follows: No bone changes (grade 0), slight bone changes (grade 1), intermediate changes (grade 2), and advanced changes (grade 3). The grading scale is easy to interpret and an otherwise troublesome communication between the radiologist and the physician was avoided. There was a high interobserver agreement with a high kappa value (0.8707). Male athletes with long-standing groin pain had abnormal bone changes in the symphysis significantly more frequently and more severely (p>0.001) than their age-matched references. In asymptomatic individuals such abnormalities increased in frequency with age both in men and women.
authors.affiliation: Department of Diagnostic Radiology, Malmö University Hospital, Malmö, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Besjakov
authors.forename: C
authors.initials: C
authors.lastname: von Scheele
authors.forename: O
authors.initials: O
authors.lastname: Ekberg
authors.forename: C F
authors.initials: CF
authors.lastname: Gentz
authors.forename: N E
authors.initials: NE
authors.lastname: Westlin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000145:classification* / Q000000981:diagnostic imaging* / Q000209:etiology; D010147:Pain Measurement; D011630:Pubic Bone / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D011631:Pubic Symphysis / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D011859:Radiography / Q000145:classification*; D012307:Risk Factors; D012720:Severity of Illness Index; D013177:Sports; D013997:Time Factors