The pubic symphysis is the midline anterior pelvic symphysis connecting the two pubic bodies through a fibrocartilaginous disc reinforced by the superior pubic ligament (above) and the arcuate pubic ligament (below). It transmits shear forces across the pelvic ring during single-leg stance and completes the pelvic ring anteriorly. Symphysis dysfunction produces groin pain, and symphysis diastasis from pelvic fracture disrupts pelvic ring stability.
Osteitis pubis (symphysis inflammation from repetitive stress in runners and footballers) produces central groin pain reproduced by resisted hip adduction and direct symphysis pressure. Symphysis widening greater than 2.5 cm on AP pelvic radiograph indicates ring disruption requiring stabilisation. Pelvic symphysis plating is performed for unstable pelvic ring injuries with anterior diastasis.
Symphyseal joint stress reaction from repetitive loading producing central groin pain in athletes managed with relative rest and injection.
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