Abstract
The case involved a 16-year-old male volleyball player, who presented with right lower abdominal pain. An abdominal CT scan showed abscess formation in the retropubic space of Retzius. Drainage of the abscess was conducted and bacterial culture identified methicilline-resistant Staphylococcus aureus. Contrast-enhanced magnetic resonance imaging (MRI) scan performed on the 5th hospital day showed the pubic bone to be continued to the abscess. Septic arthritis of the pubic symphysis (SAPS) was diagnosed and the cephem antibiotics regimen was started.
Osteitis pubis is a disease causing inflammation of the interpubic disc by its repeated overuse, and it is a common inflammatory disease in the orthopedic field. On the other hand, SAPS predominantly affects juvenile athletes. As SAPS presents with abdominal pain, inguinal pain, or abscess formation, it is often misdiagnosed as acute appendicitis or peritonitis of unknown cause. The difficulty in diagnosis of SAPS sometimes leads to recurrence or aggravation even though treatments. Aggravation of SAPS requires invasive treatments including debridement so that early diagnosis would be mandatory.
