European Journal of Radiology 27 (1998) S49 – S59 Sports injuries in the pelvis and hip: diagnostic imaging Fosco De Paulis a, *, Angelo Cacchio b , Osvaldo Michelini a , Arcadio Damiani a , Raoul Saggini c a Department of Diagnostic Imaging -CT Serice, ‘‘S. Maria di Collemaggio’’, L’Aquila Hospital, Via della Rocchetta 3 67100 Pettino -L’Aquila, Italy b Superior Institute of Physical Education, L’Aquila, Italy c Institute of Clinical Physiopatology, ‘‘G. D’Annunzio’’ Uniersity of Chieti, Chieti, Italy Abstract We discuss the role of imaging techniques in examining the athletes with sports injuries involving the pelvis and the hip. Pelvis and hip pain is of difficult clinical clarification because of the various athletic injuries which may affect the bone or soft tissues at different anatomic sites. Moreover, the symptoms of pelvis and hip injuries are similar in most cases and they are often diffuse and atypical. Diagnostic imaging can play an essential role because treatment success depends on a correct diagnosis and these techniques can actually differentiate the most frequent causes of pelvis and hip sports injuries such as groin strain, osteitis pubis, ischial intersection syndrome, snapping hip, stress fractures, hernias and avulsion fractures. Finally, we discuss the role of magnetic resonance imaging in detecting the causes of hip pain other than sports injuries, such as avascular necrosis, reflex sympathetic dystrophy syndrome, herniation pit, acetabular labrum injuries. To conclude, diagnostic imaging techniques currently permit the direct and noninvasive depiction of pelvis and hip conditions. Particularly, magnetic resonance imaging is very helpful in detecting injury site, extent and characteristics; it can also predict the time period an athlete will be disabled and help define the best treatment planning. © 1998 Elsevier Science Ireland Ltd. All rights reserved. Keywords: Sports injuries; Pelvis; Hip; Diagnostic imaging; Groin pain; Hamstring; Ischiatic intersection syndrome 1. Introduction The hip and the pelvis are commonly injured in athletes. A variety of sports injuries in the soft tissues or bones, may involve the pelvis and the hip. Groin pain, osteitis pubis, hamstring syndrome, ischiatic inter- section syndrome, avulsion fracture, stress fracture of the femoral neck and of the inferior pubic ramus, bursitis and snapping hip syndrome are just some of them. 2. The pelvis 2.1. Groin pain Groin pain is the most common finding in hip and pelvis injuries in sports, representing 2 – 5% of all sports injuries [1,2]. The symptoms of chronic groin injuries are often diffuse and indistinctive and several differen- tial diagnoses are possible. This may lead to long lasting disability and is, therefore, a major diagnostic and therapeutic challenge for sports physicians. The most common sports-related injuries in the hip, pelvis and thigh area are muscle – tendon conditions involving the adductors (adductor longus, adductor magnus, adductor brevis, pectineus and gracilis), ham- string (biceps femoris, semimembranosus, and semi- * Corresponding author. Tel.: +39 862 778854; fax: +39 862 61279. 0720-048X/98/$19.00 © 1998 Elsevier Science Ireland Ltd. All rights reserved. PII S0720-048X(98)00043-6