Pubic ramus stress fractures

1. Pubic ramus stress fractures “In a patient with a stress fracture of the inferior pubic ramus, the fracture will appear on an anteroposterior radiograph of the pelvis as a lucent line in the pubic ramus (arrow), often surrounded by callus.” ACP Medicine, www.medscape.com/viewarticle/524419_2

2. Radiograph indicating stress fracture to left pubic ramus in young adult female runner. http://running.jodidodds.com/images/pubic_20ramus.jpg

3. 21 y.o. female player injured in basketball game. AP view, right inferior pubic ramus stress fracture. Top, shortly after injury. Bottom: 1 year later.

4. 21 y.o. female player injured in basketball game. MRI. Double arrows point to right inferior pubic ramus stress fracture. Top, 3 months after injury. Bottom: 2 years later.

5. Abstract: During a four-month period we observed 12 stress fractures of the inferior pubic ramus in 11 military recruits undergoing basic training. Eleven of these were in women. This high number was considered to be caused by the introduction of mixed training of male and female recruits; this forces women to increase their stride length when marching. The presenting symptom was chronic groin pain which failed to settle with rest, and the clinical diagnoses were confirmed by radiographs in all but one patient who was diagnosed by 99mTc bone scanning. Since the required stride length has been reduced there have been no new cases of stress fracture of the pelvis. Hill et al. (1996), J Bone Joint Surg [Br]78-B:383-386. Bilateral stress fractures of the inferior pubic rami .

6. Stress fracture of the right inferior pubic ramus (left) showing callus formation six weeks after presentation (right). Hill et al. (1996), J Bone Joint Surg [Br]78-B:383-386.

7. Scintigram (99mTc) of the pelvis showing a stress fracture of the right inferior pubic ramus. Hill et al. (1996), J Bone Joint Surg [Br]78-B:383-386.