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Pubic Symphysis

symphysis pubica

The pubic symphysis is the secondary cartilaginous joint where the two pubic bones meet at the anterior pelvis, connected by a fibrocartilaginous disc and reinforced by the superior pubic ligament above and the arcuate pubic ligament below. It is not a synovial joint and allows only minimal movement — approximately 2 mm of separation during normal activities and up to 5 mm during pregnancy when the joint softens from hormonal relaxin. Symphysis dysfunction produces the debilitating anterior pelvic pain of osteitis pubis.

Region: Pelvis & Hip

Clinical Relevance

Clinical Notes

Osteitis pubis produces midline anterior pelvic pain aggravated by single-leg stance, kicking, and pivoting in athletes, reproduced by direct symphysis palpation and the bilateral adductor squeeze test. MRI shows bone marrow oedema on both sides of the symphysis. Symphysis diastasis in pelvic ring injuries requires symphysis plating when exceeding 2.5 cm. Symphysiotomy (surgical widening of the symphysis) was historically used in obstetric emergencies to widen the pelvic outlet for obstructed labour.