Chronic Pelvic pain of myofascial origin in a 53 year old patient

Abstract

Chronic pelvic pain in women has a multifactorial etiology but pelvic musculoskeletal dysfunction is not routinely evaluated as a cause by gynaecologists. There is no gold standard diagnostic test for pelvic musculoskeletal problems. Our patient presented to a gynaecologist because of chronic pelvic pain. However no gynaecological cause was found for her symptoms. This patient enjoyed sport particularly horse riding. Imaging revealed osteitis pubis and an osteophyte of the sacro-ilium. It has been recognised in athletes that there can be an association between stress injuries to the pubic symphysis and degenerative changes at the sacro-ilium. This case demonstrates the importance of thinking of a myofascial cause for chronic pelvic pain.