# Idiopathic Pubic Symphysis Diastasis in a Patient With Autosomal Dominant Polycystic Kidney Disease: A Rare Case Report

## TL;DR

A young woman with a rare kidney disease developed an unusual pelvic condition, which was managed without surgery.

## Contribution

This is the first reported case of idiopathic pubic symphysis diastasis in a patient with autosomal dominant polycystic kidney disease.

## Key findings

- A 22-year-old female with ADPKD was diagnosed with idiopathic pubic symphysis diastasis.
- The patient's condition was managed conservatively with physical therapy and activity modification.
- This case expands the known musculoskeletal manifestations of ADPKD.

## Abstract

Pubic symphysis diastasis (PSD) is characterized by widening of the pubic symphysis, most often associated with pregnancy, childbirth, or trauma, while idiopathic PSD is exceedingly rare. Autosomal dominant polycystic kidney disease (ADPKD) is a multisystem disorder, but PSD has not been previously reported in this context. We present a 22-year-old female with ADPKD and progressive hip discomfort and clicking since childhood. Examination revealed mildly restricted, painful hip motion without instability. Radiography showed a pubic symphysis width of 25.5 mm, with no sacroiliac, traumatic, or degenerative findings. With no obstetric, traumatic, or inflammatory history, idiopathic PSD was diagnosed. The patient was managed conservatively with physical therapy, activity modification, and orthopedic follow-up. This is the first reported case of idiopathic PSD in an ADPKD patient, expanding the spectrum of musculoskeletal manifestations in ADPKD and highlighting the need to consider pelvic structural disorders in unexplained hip or pelvic pain.