We had noticed that pain on palpation of the hemipubis is found in one third of patients with PMID of the thoracolumbar junction (T11-12, T12-L1; Fig. 56.1). The affected hemipubis is ipsilateral to the articular pain of the PMID. In chronic cases, the condition may become bilateral (see Chapter 60, “Thoracolumbar Junction Syndrome”). These patients are usually unaware of having pubic sensitivity, and they are very surprised when it is discovered at the insertion of the rectus abdominis muscle or on the whole surface of the bone (Fig. 56.2). Frequently, a cellulalgic zone painful to pinch-rolling, overlying the ipsilateral groin and superomedial thigh, is detected on examination. Sometimes, one or two small trigger points are found in the inferior aspect of the rectus abdominis and are very painful to palpation (Fig. 56.3).