Is Groin Hernia Associated with Pubic Edema Severity in Footballers?

Objective: The groin area, with its complex anatomical structure, can have different athletic problems simultaneously. In this study, it was aimed to investigate whether groin hernia had a relationship with pubic bone marrow edema (BME) severity in footballers. Method: Among the athletes with painful groin from different sports, only male footballers who had pubic BME in pelvic MRI report were included in the study. The included athletes underwent a second archive scan for groin hernia (hernia symptoms, previous hernia surgery, sonography report). Then, the MRI sections of hernia-related cases were re-evaluated. For this purpose, right and left pubic BME signal intensities (SI) were quantitatively measured using "region of interest (ROI)" program module on T2 fat-suppressed images. Results: A total of 93 footballers with pubic BME were found. Eleven of them (11.8%) had a concurrent hernia, while five (5.4%) had a repaired hernia prior to study. ROI measurements of these sixteen athletes revealed that the pubic bones on the side of concurrent and repaired hernia had a significantly greater mean BME intensity than opposite pubic bones (1049 SI versus 796 SI, p<0.001). Conclusion: A groin hernia can be seen concurrently in one-tenth of footballers with pubic BME. Whether the hernia is concurrent or repaired, its side overlaps with the side of serious pubic BME. There is significant association between hernia and pubic BME severity in terms of groin selection. Strength / flexibility imbalance between the groin sides or leg dominancy can be research subject in this context.