Stress Fracture of the Pubic Ramus With Associated Osteitis Pubis in a Young Football Player: A Case Report

We report the case of a 21-year-old male semi-professional football player presenting with a one-month history of progressive inguino-pubic pain without a history of acute trauma. Clinical examination revealed point tenderness over the pubic symphysis and pain on resisted adductor contraction. Standard pelvic radiographs were unremarkable. Magnetic resonance imaging (MRI) demonstrated a stress fracture of the left inferior pubic ramus with associated stress reaction of the pubic body, osteitis pubis, and oedema at the left adductor insertion. Conservative management comprising immediate cessation of sporting activity, progressive protected weight bearing, analgesia, and structured physiotherapy resulted in complete resolution of symptoms and a gradual return to competitive football without complications. Stress fractures of the pubic symphysis should be considered in the differential diagnosis of groin pain in athletes. MRI is the imaging modality of choice for early diagnosis and characterisation of associated soft-tissue lesions. Conservative treatment with structured rehabilitation yields favourable outcomes.