Sports hernia MRI

These MRI images are from a young soccer player who presented with pain in the pubic area and groin bilaterally.

(A) Sagittal short tau inversion recovery (STIR) pulse sequence MRI through the midline at the level of the pubic symphysis demonstrates separation of the rectus abdominis/adductor aponeurotic plate from the bone (arrow).

(B) Coronal T2-weighted MRI demonstrates the partial tear of the pubic insertion of the adductor tendons bilaterally (arrowheads; double secondary cleft sign or "mustache sign").