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Pubic Symphysis

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Introduction

Pubic Symphysis[1]
Normal pelvic radiograph including normal appearance of the pubic symphysis[2]
Anatomy of the pubic symphysis
Anterior view illustration shows the myotendinous attachments surrounding the pubic symphysis, with the muscles shown on the left and their attachments shown on the right. Emphasized with asterisks, the rectus abdominis (red) and adductor longus (dark blue) are the most important muscles for maintaining anterior pelvic stability via their aponeurosis (black zigzag). Paired adductor longus tendons merge across the midline, which has been described as a “moustache” configuration. In the sagittal plane (rotated rectangular cutout on the right), the counterbalance of the rectus abdominis and adductor longus is depicted. A = anterior, L = lateral head of rectus abdominis, M = medial head of rectus abdominis, P = posterior.[3]

Other Names

  • Pubic Symphysis (english)
  • Symphysis Pubica (latin)

Origin

  • Fibrocartilaginous joint
    • Formed by the left and right superior pubic rami of the two pubic bones
    • Non-synovial, non-vascular amphiarthrodial joint
    • Wedge-shaped intperubic disc between the two layers of hyaline cartilage

Ligaments

  • Four ligaments maintain its supportive integrity
  • Superior and Inferior Pubic Ligament: provide most of the stability
  • Anterior and Posterior ligaments: less important

Muscle Attachments

Developmental Changes

  • Normal width varies at different ages
    • 10 mm (3 years)
    • 6 mm (20 years)
    • 3 mm (50 years)

Actions

  • Movement: very little, max 2 mm shift, 1° rotation[4]
    • Up to 3 mm can occur after more than two pregnancies[5]
  • Form the anterior component of the pelvic ring
  • Helps transfer weight from upright trunk to the hips
  • Facilitates delivery of baby during child birth

Vascular Supply

  • Branches of
    • Obturator Artery
    • Inferior Epigastric Artery

Innervation

  • Branches of
    • Pudendal Nerve
    • Genitofemoral Nerve
    • Hypogastric/ Ilioinguinal Nerve

Clinical Significance

See Also

References

  1. ↑ Image courtesy of kenhub.com
  2. ↑ Case courtesy of Luke Danaher, Radiopaedia.org, rID: 39777
  3. ↑ So, Connie C., Lillian S. Niakan, and Ricardo D. Garza-Gongora. "Imaging of the Pubic Symphysis: anatomy and pathologic conditions." RadioGraphics 43.2 (2023): e220058.
  4. ↑ Becker I, Woodley SJ, Stringer MD. The adult human pubic symphysis: a systematic review. J. Anat. 2010;217 (5): 475-87.
  5. ↑ Giannoudis PV: Instability of the pelvic ring: a special clinical entity?. J Clin Med. 2020, 9:10.3390/jcm9061985
Created by:
John Kiel on 14 July 2020 17:36:15
Authors:
Last edited:
8 June 2025 16:46:16
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