title: Effect of heavy training in contact sports on MRI findings in the pubic region of asymptomatic competitive athletes compared with non-athlete controls.
abstract: OBJECTIVE
  Bone marrow edema (BME) at the pubic symphysis on magnetic resonance imaging (MRI) is usually associated with groin pain and stress injury of the pubic bone. Little is known of the pubic MR imaging findings of asymptomatic heavy training athletes in contact sports.
  
  
  METHODS
  Pelvic MRI of male asymptomatic soccer (n=10), ice hockey (n=10), bandy (n=10) and female floor-ball players (n=10) were compared with non-athlete controls (10 males, 10 females) without groin pain to analyse the presence of BME (on a four-point scale). To study the possible changes of BME directly following heavy physical activity, 10 bandy players underwent MRI before and immediately after a 2-h training session.
  
  
  RESULTS
  Magnetic resonance imaging showed minimal BME (grade 1) at the pubic symphysis in 19 of the 40 athletes (48%). Two soccer and 2 ice hockey players (20%) had moderate grade 2 pubic edema, but severe grade 3 BME findings were not found. Also 10 out of 20 (50%) of controls had grade 1 BME. The extent of increased signal was equally distributed in the asymptomatic athletes of different contact sports and controls. A heavy 2-h training session did not cause any enhanced signal at the pubic symphysis.
  
  
  CONCLUSIONS
  This study indicates that the presence of grade 1 pubic BME was a frequent finding in contact sports and comparable to that in non-athletes. Grade 2 BME was found only in asymptomatic athletes undergoing heavy training.
authors.affiliation: Department of Surgery, Kuopio University Hospital, 70211, Kuopio, Finland. hannu.paajanen@kuh.fi
authors.forename: Hannu
authors.initials: H
authors.lastname: Paajanen
authors.forename: Heikki
authors.initials: H
authors.lastname: Hermunen
authors.forename: Jari
authors.initials: J
authors.lastname: Karonen
mesh_terms: D000328:Adult; D056352:Athletes; D001265:Athletic Injuries; D001853:Bone Marrow / Q000000981:diagnostic imaging* / Q000473:pathology; D004487:Edema / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D011630:Pubic Bone / Q000000981:diagnostic imaging* / Q000293:injuries / Q000473:pathology; D011859:Radiography